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Inguinal Hernia in Premature Infants.

Venkataraman Ramachandran1, Charles F Edwards2, Dana C Bichianu3

  • 1Departments of Surgery.

Neoreviews
|June 3, 2020
PubMed
Summary

Inguinal hernia is common in preterm infants in the NICU, with risk increasing as gestational age decreases. Optimal surgical timing and repair methods require further investigation due to unclear causes and limited trials.

Area of Science:

  • Neonatal surgery
  • Pediatric surgery
  • Gastroenterology

Background:

  • Inguinal hernia is a frequent complication in neonatal intensive care unit (NICU) infants.
  • Preterm infants exhibit the highest incidence, escalating with reduced gestational age.
  • Etiopathologic factors and preventative interventions remain poorly understood.

Purpose of the Study:

  • To review current understanding of inguinal hernia in NICU infants.
  • To highlight diagnostic challenges, including distinguishing strangulation from obstruction.
  • To discuss controversies in surgical timing, anesthesia, and repair techniques.

Main Methods:

  • Literature review of existing studies on inguinal hernia in NICU populations.
  • Analysis of diagnostic modalities, including ultrasonography.

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  • Examination of surgical approaches (open vs. laparoscopic) and anesthesia choices (regional vs. general).

    • Main Results:

    • Diagnosis can be challenging, sometimes requiring advanced imaging.
    • Optimal surgical timing is not established and influenced by infant comorbidities.
    • Clinical experience correlates with reduced surgical morbidity; various repair techniques exist.

    Conclusions:

    • Inguinal hernia management in NICU infants necessitates a multidisciplinary approach.
    • Further research, including randomized controlled trials, is crucial for optimizing surgical timing and techniques.
    • Anesthesia choices should be individualized based on patient condition and surgical team expertise.