Acute Inguinoscrotal Lesions in Children- Aetiology, Effects of Delayed Presentation on Management and Outcome in Benin City, Nigeria

Abstract

Acute inguinoscrotal lesion is common in children and it may be associated with irreversible vital organ damage if prompt medical attention is not given. The objective of the study is to determine the etiology and effects of late presentation on the management and outcome of acute inguinoscrotal lesions in a developing country. A prospective study on consecutive male children that presented with acute inguinoscrotal lesions at the University of Benin Teaching Hospital, Benin City, Nigeria between January, 2003 and December 2007. The Etiology, causes of late presentation and its effects on management/outcome were documented on a structured pro forma and analyzed using SPSS version 11. A total of 126 children aged between 3 weeks and 16 years (average 10.5 years) accounting for 15.7% of patients who presented with urological ailments, were managed for acute inguinoscrotal lesions. Obstructed inguinoscrotal hernia 43 (34.1%), groin lymphadenitis 39 (31.0%) and testicular torsion 21 (16.7%) were common while inflamed undescended testes 9 (7.1%), epididymoorchitis 7 (5.6%), trauma 5 (4.0%) and perineal burns 2 (1.6%) were rare. Majority [76 (60.3%)] of the children resided in rural areas where there were no adequate healthcare facilities and unorthodox
medications were the first line of management with resultant delayed presentation and unacceptably high complications particularly among the younger children and neonates (P=0.0251). Overall, 7 (5.6%) children had unilateral orchidectomy due to irreversible testicular damage and 5 (4.0%) bowel resections/anastomosis due to neglected strangulated inguinal
hernias. Delayed presentation was due to ignorance and unavailable healthcare facilities which significantly affected outcome with unacceptable irreversible complications that showed the need for public enlightenment campaign aimed at increased awareness.

Keywords: Acute, Inguinoscrotal, Lesion, Children, Presentation, Outcome