Bandré E, Kaboré R A F, Sanou A, Ouédraogo I, Soré O, Tapsoba T, Nébié B, Wandaogo A, Bachy B
Service de chirurgie pédiatrique, CHU pédiatrique Charles-de-Gaulle, 01 BP 1198, Ouagadougou 01, Burkina Faso.
Bull Soc Pathol Exot. 2010 May;103(2):100-3. doi: 10.1007/s13149-010-0039-y. Epub 2010 Feb 25.
Umbilical hernias occur frequently in children but complications are rarely reported. This study assesses the incidence of complicated umbilical hernias in our patients, evaluates data for risk factors, and shows dissimilarities with those encountered in developed countries. This study reports all children operated for complications due to strangulated umbilical hernia over a period of 3 years. On the whole, 162 children had umbilical hernias treated during this period. Thirty (18.5%) of these had complicated hernias. The average age of the complicated group was 3(1/2) years. Twenty-nine cases had a painful irreducible umbilical mass. Twenty-four children had bowel obstruction, while stercoral fistula occurred in one child. The average diameter of the hernia ranged between 1 and 1.5 cm. Five patients had ischemic intestine that required resection. One patient died. When active observation and follow-up after 1 year is difficult or not feasible when the wall defect diameter is 1.5 cm or less, and in suspicion of incarceration (unexplained abdominal pain, and irreducibility), umbilical hernia should be operated.
脐疝在儿童中很常见，但并发症很少见报道。本研究评估了我们患者中复杂脐疝的发生率，评估了危险因素的数据，并显示了与发达国家所遇到情况的差异。本研究报告了3年内因绞窄性脐疝并发症接受手术的所有儿童。总体而言，在此期间有162名儿童接受了脐疝治疗。其中30例（18.5%）为复杂疝。复杂组的平均年龄为3.5岁。29例有疼痛且不能回纳的脐部肿物。24名儿童发生肠梗阻，1名儿童出现粪瘘。疝的平均直径在1至1.5厘米之间。5例患者有缺血性肠管需要切除。1例患者死亡。当壁缺损直径为1.5厘米或更小时，1年后难以或无法进行积极观察和随访，且怀疑有嵌顿（不明原因腹痛和不能回纳）时，应进行脐疝手术。
