SURGICAL MANAGEMENT OF OBSTRUCTED PEDIATRIC INGUINAL HERNIAS
Main Article Content
Keywords
Pediatric inguinal hernia, obstructed hernia, surgical management, laparoscopic repair, open repair, outcome
Abstract
Background: Inguinal hernias in children are emergency surgeries whereby if not treated early may lead to complications that require risk management. If management is delayed, complications including ischemia, necrosis and severe morbidity may occur.
Objective: The objective of this study was to assess demographic data, clinical profile, management strategies, and outcome of children presenting with obstructed inguinal hernias.
Methods: A descriptive cross-sectional study was conducted for about 5 months from July, 2011 to Nov, 2011 in the Department of Paediatric Surgery, Khalifa Gulnawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan. In this study, 150 children with direct inguinal hernia were selected. The clinical data such as demographics, clinical history, operative observations, procedures performed and the outcome were recorded on a proforma. Data analysis was done using SPSS, and the level of significance was set at p < 0.05.
Results: The study included 150 patients, with a male-to-female ratio of 4:1. The mean age was 5.2 years (range: 1–12). Right-sided hernias were the most common (66.7%), followed by left-sided (26.7%) and bilateral hernias (6.6%). Acute symptoms were reported in 73.3% of cases, with pain and swelling being the most common complaints. Most hernias were indirect (90%), and 13.3% were strangulated. Open surgical repair was performed in 80% of cases, while laparoscopic repair accounted for 20%. Postoperative complications were minimal, with recurrence reported in only 1.3% of patients. There were no mortalities, and the average hospital stay was 3.2 days.
Conclusion: This study highlights the predominance of obstructed inguinal hernias in male children and the acute nature of most presentations. Open repair remains the preferred surgical approach in resource-limited settings, with excellent outcomes and minimal complications. Early diagnosis and timely surgical intervention are critical in reducing morbidity and ensuring favourable outcomes.
Objective: The objective of this study was to assess demographic data, clinical profile, management strategies, and outcome of children presenting with obstructed inguinal hernias.
Methods: A descriptive cross-sectional study was conducted for about 5 months from July, 2011 to Nov, 2011 in the Department of Paediatric Surgery, Khalifa Gulnawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan. In this study, 150 children with direct inguinal hernia were selected. The clinical data such as demographics, clinical history, operative observations, procedures performed and the outcome were recorded on a proforma. Data analysis was done using SPSS, and the level of significance was set at p < 0.05.
Results: The study included 150 patients, with a male-to-female ratio of 4:1. The mean age was 5.2 years (range: 1–12). Right-sided hernias were the most common (66.7%), followed by left-sided (26.7%) and bilateral hernias (6.6%). Acute symptoms were reported in 73.3% of cases, with pain and swelling being the most common complaints. Most hernias were indirect (90%), and 13.3% were strangulated. Open surgical repair was performed in 80% of cases, while laparoscopic repair accounted for 20%. Postoperative complications were minimal, with recurrence reported in only 1.3% of patients. There were no mortalities, and the average hospital stay was 3.2 days.
Conclusion: This study highlights the predominance of obstructed inguinal hernias in male children and the acute nature of most presentations. Open repair remains the preferred surgical approach in resource-limited settings, with excellent outcomes and minimal complications. Early diagnosis and timely surgical intervention are critical in reducing morbidity and ensuring favourable outcomes.
References
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3. Tovar JA. Inguinal hernia. Newborn Surgery, Oxford: Butterworth-Heinemann. 2003.
4. Micha Bahr M, Baur C, Richter KK. LONG TERM RESULTS AFTER LAPAROSCOPIC INGUINAL HERNIA REPAIR IN CHILDREN.
5. Katz DA. Evaluation and management of inguinal and umbilical hernias. Pediatric annals. 2001;30(12):729-35.
6. NEW BVI. Pediatric surgery. INDIAN JOURNAL OF PRACTICAL PEDIATRICS. 2004;6(1):32.
7. Manoharan S, Samarakkody U, Kulkarni M, Blakelock R, Brown S. Evidence-based change of practice in the management of unilateral inguinal hernia. Journal of pediatric surgery. 2005;40(7):1163-6.
8. Mbah N. Morbidity and mortality associated with inguinal hernia in Northwestern Nigeria. West African journal of medicine. 2007;26(4):288-92.
9. Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. The Lancet. 2003;362(9395):1561-71.
10. Brandt ML. Pediatric hernias. Surgical Clinics of North America. 2008;88(1):27-43.
11. Usang U, Sowande O, Adejuyigbe O, Bakare T, Ademuyiwa O. Day case inguinal hernia surgery in Nigerian children: Prospective study. African Journal of Paediatric Surgery. 2008;5(2):76-8.
12. Charles N, Christian L, Sen T, Mahapatra S, Joshi B. A two year retrospective study of congenital inguinal hernia at western regional hospital, Nepal. J Nep Med Assoc. 2000;39(133):172-5.
13. Ein SH, Njere I, Ein A. Six thousand three hundred sixty-one pediatric inguinal hernias: a 35-year review. Journal of pediatric surgery. 2006;41(5):980-6.
14. Misra D. Inguinal hernias in premature babies: wait or operate? Acta Paediatrica. 2001;90(4):370-1.
15. Conze J, Klinge U, Schumpelick V. Hernias. Surgical treatment: evidence-based and problem-oriented: Zuckschwerdt; 2001.
16. Aasvang E, Kehlet H. Surgical management of chronic pain after inguinal hernia repair. Journal of British Surgery. 2005;92(7):795-801.
17. Samad A, Sheikh GM. Spontaneous fecal fistula: a rare presentation of inguinal hernia. Journal of Ayub Medical College Abbottabad. 2005;17(4).
18. Murphy JJ, Swanson T, Ansermino M, Milner R. The frequency of apneas in premature infants after inguinal hernia repair: do they need overnight monitoring in the intensive care unit? Journal of pediatric surgery. 2008;43(5):865-8.
19. Garcia EA. Intestinal obstruction in infants and children. Clinical Pediatric Emergency Medicine. 2002;3(1):14-21.
20. Gopinath G, Nagaraj P, Kulkarni M. Obstructed umbilical hernia in a child with Hurler's syndrome. 2005.
21. Osifo O, Irowa O. Indirect inguinal hernia in Nigerian older children and young adults: is herniorrhaphy necessary? Hernia. 2008;12:635-9.
2. Hanumanthappa P. Clinical Study of Inguinal Hernias in Paediatric Age Group: Rajiv Gandhi University of Health Sciences (India); 2005.
3. Tovar JA. Inguinal hernia. Newborn Surgery, Oxford: Butterworth-Heinemann. 2003.
4. Micha Bahr M, Baur C, Richter KK. LONG TERM RESULTS AFTER LAPAROSCOPIC INGUINAL HERNIA REPAIR IN CHILDREN.
5. Katz DA. Evaluation and management of inguinal and umbilical hernias. Pediatric annals. 2001;30(12):729-35.
6. NEW BVI. Pediatric surgery. INDIAN JOURNAL OF PRACTICAL PEDIATRICS. 2004;6(1):32.
7. Manoharan S, Samarakkody U, Kulkarni M, Blakelock R, Brown S. Evidence-based change of practice in the management of unilateral inguinal hernia. Journal of pediatric surgery. 2005;40(7):1163-6.
8. Mbah N. Morbidity and mortality associated with inguinal hernia in Northwestern Nigeria. West African journal of medicine. 2007;26(4):288-92.
9. Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. The Lancet. 2003;362(9395):1561-71.
10. Brandt ML. Pediatric hernias. Surgical Clinics of North America. 2008;88(1):27-43.
11. Usang U, Sowande O, Adejuyigbe O, Bakare T, Ademuyiwa O. Day case inguinal hernia surgery in Nigerian children: Prospective study. African Journal of Paediatric Surgery. 2008;5(2):76-8.
12. Charles N, Christian L, Sen T, Mahapatra S, Joshi B. A two year retrospective study of congenital inguinal hernia at western regional hospital, Nepal. J Nep Med Assoc. 2000;39(133):172-5.
13. Ein SH, Njere I, Ein A. Six thousand three hundred sixty-one pediatric inguinal hernias: a 35-year review. Journal of pediatric surgery. 2006;41(5):980-6.
14. Misra D. Inguinal hernias in premature babies: wait or operate? Acta Paediatrica. 2001;90(4):370-1.
15. Conze J, Klinge U, Schumpelick V. Hernias. Surgical treatment: evidence-based and problem-oriented: Zuckschwerdt; 2001.
16. Aasvang E, Kehlet H. Surgical management of chronic pain after inguinal hernia repair. Journal of British Surgery. 2005;92(7):795-801.
17. Samad A, Sheikh GM. Spontaneous fecal fistula: a rare presentation of inguinal hernia. Journal of Ayub Medical College Abbottabad. 2005;17(4).
18. Murphy JJ, Swanson T, Ansermino M, Milner R. The frequency of apneas in premature infants after inguinal hernia repair: do they need overnight monitoring in the intensive care unit? Journal of pediatric surgery. 2008;43(5):865-8.
19. Garcia EA. Intestinal obstruction in infants and children. Clinical Pediatric Emergency Medicine. 2002;3(1):14-21.
20. Gopinath G, Nagaraj P, Kulkarni M. Obstructed umbilical hernia in a child with Hurler's syndrome. 2005.
21. Osifo O, Irowa O. Indirect inguinal hernia in Nigerian older children and young adults: is herniorrhaphy necessary? Hernia. 2008;12:635-9.
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Published
Feb 18, 2012
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How to Cite
Dr. Muhammad Jehangir Khan. (2012). SURGICAL MANAGEMENT OF OBSTRUCTED PEDIATRIC INGUINAL HERNIAS. Journal of Population Therapeutics and Clinical Pharmacology, 19(1), 92-99. https://doi.org/10.53555/7p85k355
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Author Biography
Dr. Muhammad Jehangir Khan
Associate Professor, Department of Paediatric Surgery, Khalifa Gulnawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan.
How to Cite
Dr. Muhammad Jehangir Khan. (2012). SURGICAL MANAGEMENT OF OBSTRUCTED PEDIATRIC INGUINAL HERNIAS. Journal of Population Therapeutics and Clinical Pharmacology, 19(1), 92-99. https://doi.org/10.53555/7p85k355