Incarcerated and strangulated inguinal hernias in children in Zaria, Nigeria.

OBJECTIVE

To reappraise the problem of incarcerated and strangulated inguinal hernias in children in Zaria, Nigeria.

DESIGN

A retrospective study.

SETTING

Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.

PATIENTS

Eighteen children aged below two years with incarcerated and strangulated inguinal hernias managed over a 10 year period.

MAIN OUTCOME MEASURES

Incarceration and strangulation rate, resection rate, testicular infarction, wound infection.

RESULTS

The overall incarceration and strangulation rate was 4.8%. The rate in neonates was 80%, 33% in those less than six months and 21% in those below one year. There was no incarceration or strangulations after two years of age. The intestinal resection rate for gangrene was 11% (two neonates) and ipsilateral orchidectomy was necessary for testicular infarction in two neonates (11%). Wound infection occurred in three patients (17%) and there were no deaths. Overall, there has been an improvement in the incarceration and strangulation rate, resection rate and wound infection rate over earlier years (5.7%, 28% and 50% respectively for earlier years) due largely to early presentation. Testicular infarction, however, remains a major risk particularly in neonates.

CONCLUSION

The policy of early repair of inguinal hernias in children especially below two years and particularly in neonates should be continuously emphasised to avoid morbidity.