Irreducible Inguinal Hernias in the Paediatric Age Group

Abstract

BACKGROUND: An inguinal hernia is said to be irreducible when the content fails to return into the peritoneal cavity without surgical intervention. Irreducibility is an ever present risk in untreated inguinal hernias and its management remains an important part of pediatric surgery practice. When a hernia is irreducible , morbidity and mortality increase.This risk of irreducibility is more in some patient groups.
METHODS: A retrospective analysis of all irreducible inguinal hernias in children of both sexes from neonatal age to 15years who presented at the University of Nigeria Teaching Hospital from January 2000 to June 2010 and needed emergency groin exploration when reduction failed on conservative management.
RESULTS: There were 25 irreducible inguinal hernias requiring emergency groin exploration. This represents 10.2% of all inguinal hernias managed within the period ,with a male :female ratio of 11.5 :1. Nineteen(76%) were on the right while six(24%) were on the left. Forty percent(40%) of the irreducible hernias were in older infants. Sixty-seven(67%) of the neonatal hernias presented as irreducible. There were 3 bowel resections
(12% bowel resection rate), 2 testicular losses(8% testicular loss rate) and one death(4% mortality).
CONCLUSION :There is a high rate of irreducibility of inguinal hernias in neonates , and in right-sided hernias .Identification of risk factors in and risk stratification of patients with uncomplicated inguinal hernias will help
reduce the rate of irreducible inguinal hernias and their attendant morbidities.

KEY WORDS: Irreducible ; Inguinal hernia ;Pediatric