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Femoral hernia in pediatric population: a diagnostic and surgical challenge
Cristina Martucci1, Simone Frediani2, Antonella Accinni2
1Department of Surgery, General and Thoracic Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, Italy. cristina.martucci@opbg.net.
Insights
Femoral hernia (FH) in children is rare and frequently misdiagnosed. Improving diagnostic accuracy and surgical planning is crucial for better outcomes in pediatric patients with this condition.
Area of Science:
- Pediatric Surgery
- Surgical Pathology
- Herniology
Background:
- Femoral hernia (FH) is an uncommon condition in the pediatric population.
- FH is often misdiagnosed, presenting diagnostic challenges for clinicians.
Purpose of the Study:
- To describe the experience of a tertiary center in managing pediatric femoral hernias.
- To highlight diagnostic and surgical details to improve FH management in children.
Main Methods:
- Retrospective study of pediatric patients undergoing FH repair.
- Data collected from January 2010 to June 2023.
Main Results:
- 31 pediatric patients with FH were analyzed.
- A 35.5% pre-operative misdiagnosis rate was observed.
- Low complication rate (6.4%) with open repair, including one recurrence and one hematoma.
Conclusions:
- Femoral hernia in children presents diagnostic and surgical challenges.
- Accurate clinical examination is vital for correct diagnosis and surgical planning.
- Preventing post-operative complications requires careful management.
Purpose:
Femoral hernia (FH) is a rare and often misdiagnosed pathology in pediatric population. The aim of our study was to describe the experience of a Tertiary Center in children with FH, underlying diagnostic and surgical details that could improve its management.
Methods:
A retrospective study of pediatric patients who underwent FH repair from January 2010 to June 2023 at our Institution was performed.
Results:
In the analyzed period, 31 patients underwent surgical procedure for FH at our institution, of whom 16 (51.6%) were female. The mean age at time of surgery was 5.8 years (range 0.5-17.1 years). The rate of pre-operative misdiagnosis was 35.5% and open approach was adopted in all cases (16.1% with mesh application). Only two patients (6.4%) experienced surgical complications: one recurrence (repaired six months later) and one post-operative hematoma (treated successfully with conservative method).
Conclusion:
Due to the high rate of misdiagnosis, the variety of surgical approaches proposed, and the potential for intraoperative complications, FH poses a challenge for pediatric surgeons and urologists, as confirmed by the literature. It is essential to underline the importance of a proper clinical examination in order to correctly diagnose FH, make the best surgical plan for the patient and prevent post-operative complications.
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