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[Complications of inguinal hernia in children]
M Schmitt1, B Peiffert, G de Miscault
1Clinique Chirurgicale Pédiatrique, CHU, Nancy.
Insights
This study analyzed 679 pediatric inguinal hernia surgeries. Findings indicate premature infants have higher risks of bilateral and incarcerated hernias, and incarceration poses greater testicular risks than elective surgery.
Area of Science:
- Pediatric Surgery
- Urology
- Neonatology
Context:
- Inguinal hernias are common in pediatric surgery.
- Understanding hernia characteristics in different patient groups is crucial for surgical planning.
- The study reviewed 679 pediatric inguinal hernia cases from 1978-1985.
Purpose:
- To analyze surgical outcomes and characteristics of inguinal hernias in different pediatric patient groups.
- To evaluate the incidence of bilateral hernias, incarceration, and associated complications.
- To assess the impact of prematurity on hernia presentation and outcomes.
Summary:
- Bilateral inguinal hernias were observed in 119 children, with 46 requiring reoperation; prematurity was more frequent in this group.
- 177 children (26%) presented with incarcerated inguinal hernias, often in infants under 3 months, with 8 cases of testicular infarction.
- Premature infants (126) showed higher rates of bilateral and incarcerated hernias, with some benefiting from surgery regarding recurrent apnea.
Impact:
- The study highlights that inguinal hernia incarceration carries a higher risk of testicular lesions than elective hernioplasty.
- Findings support surgical intervention for inguinal hernias in children of all ages, including premature infants.
- Early surgical management may be beneficial for premature infants with recurrent apnea episodes.
Abstract:
From 1978 to 1985, 679 boys were operated for an inguinal hernia. 3 groups of patients must be considered. The bilateral inguinal hernias group (119 children) 73 patients were operated on both sides. 46 presented signs of hernia on the opposite side after the first operation and were operated again. In this group, there is a more important frequency of premature. But the classical notion that bilateral hernia are more common when the presenting hernia is on the left side, is not noticed. As a matter of fact, among the 46, there were 33 children operated at first on the right side. If a systematic bilateral exploration had been realised, it would here been useless in 82 per cent of the cases. The incarcerated inguinal hernia group 177 (26%) children were hospitalised for an incarcerated inguinal hernia diagnosis. 23 infants required emergency operation. Mostly, it was the first episode of a right hernia in a child under 3 months of age. 8 times a testicular infarction was noticed. The incidence of testicular lesion following incarceration of inguinal hernia is more important that the testicular atrophy after primary hernioplasty. This justify the surgical treatment for children of any age. The premature group 126 children were premature infants. In this group, a more important frequency of bilateral and incarcerated hernias are noted. 24 among these patients presented recurrent apnea episodes. To 8 of those children, the intervention was probably a benefit for the evolution of their apneas.(ABSTRACT TRUNCATED AT 250 WORDS)