Could incarceration of inguinal hernia in children be prevented?

BACKGROUND

The aim of this study was to determine the incidence of incarceration in children with congenital inguinal hernias and to ascertain if incarceration could have been prevented.

MATERIAL/METHODS: Records of 1582 children who underwent inguinal herniorrhaphy between 1993 and 2000 were analysed regarding the time and circumstances of hernia incarceration.

RESULTS

Incarcerated hernia developed in 153 cases (9.7%) developed, of whom 81 (52.9%) were known to have had prior hernia incarceration and 81 (52.9%) were under one year of age. Manual reduction of hernia was successful in 130 cases (85%), and 99 of them (76.2%) underwent hernia repair during the same stay. Emergency surgery was necessary in a total of 36 children (23.5%), 23 with the first and 13 with the second incarceration episode. Complications occurred in 16 children with incarcerated hernia (10.4%), including intestinal necrosis, omentum and appendix infarction, infarction of the testis, torsion of the ovary, recurrent hernia and wound infection.

CONCLUSIONS

The first incarceration of known inguinal hernia could have been avoided in more than half of our patients and the second in one-fourth after successful manual reduction.