A Clinical Study on the Management of Inguinal Hernias in Children on the General Surgical Practice

Abstract

Background: Inguinal and scrotal swellings are frequently encountered in the surgical practice, especially in children. It is also important to study the factors which are associated with inguinal hernia, especially in children, for its effective management.Objective: To study the factors which are associated with inguinal hernia in children. Setting and Design:A prospective hospital based study was undertaken in the Department of Surgery for a period of one year between 2001 to 2002. Children who were aged one day to 12 years were selected for the study. Out of 960 children who were admitted to the surgical ward, 50 children had inguinal hernia and they constituted the sample. Methodology:The details regarding the clinical history and the examination details were collected by using a predesigned proforma. The data which was thus collected was analyzed by using the appropriate statistical tests. Results:The inguinal hernia in the study group was common in the 1-5 years age group. 90% of the study group was males; a swelling in the inguinal region was the commonest symptom. 70% of the study group was term deliveries; the swelling of the inguinal hernia was elastic in consistency in 35 cases. The swelling of the inguinal hernia was irreducible in two cases. The testis was palpable in 48 cases; a cough impulse was seen and felt in 48 cases. Tenderness of the swelling was present in 2 cases. Conclusions:Inguinal hernia is a common congenital condition in children. Difficulties are commonly encountered by the surgeons to identify and to confirm the presence of inguinal hernia. This study will help in a better management of hernia in the paediatric age group by understanding the features of inguinal hernia.V. RaViKumaR, RajshanKaR s, haReesh R. s. KumaR, nagendRa goWda m.R InTRODuCTIOnInguinal and scrotal swellings in children are frequently encountered in the surgical practice. Most of these swellings are congenital and they have an asymptomatic presentation. They are related to the descent of the testes and the processus vaginalis [1]. To date, the mechanism of the testicular descent is speculative, with various hypotheses being put forth, the most recent one being that of "WATER-TRAP" which was made by Heyns and Deklerk. The abnormalities in the descent result in ectopic or undescended testes. The undescended testis which is found in more than 90% of the cases, is associated with congenital inguinal hernias [2].Congenital inguinal hernias are common in infants and children, for which surgery constitutes the most frequent method of treatment in the paediatric age-group. The difficulties which are encountered in paediatric inguinal hernia are operative difficulties which are connected with a thin transparent sac, which is the association with the undescended testis and the different opinions on the timing of the operation when the two conditions co-exist. The swelling in the inguinal region is described by the parent but the surgeon is unable to confirm its presence. Once the diagnosis is definite, the rule i...

The demographic profile and the management of infantile inguinal hernia: a 3-year’s review

“…Hence, the male predominance was seen in both the groups. Literature review reveals the ratio as, 6:1 by Poenarau et al, 7:1 by Grossfeld et al, 9:1 by Ravikumar et al and 11.5:1 by Jadhav et al [5][6][7]. Ours is the only series, which showed lower sex ratio despite lower socioeconomic status and the general public awareness.…”

“…Rowe et al reports incarceration more on right-sided inguinal hernias (17%) compared to left (7%) in their series; whereas, our result shows just the opposite; having left-sided hernia presenting with irreducibility 5 (62.5%) in GI and 2 (66%) in GII. Rowe et al, recommends elective surgery after a reduction, since it has a lower rate of complications as compared to an emergency surgery (1.7% vs. 22.1%) [6,8,9,22]. In our institute also, we operate these babies as soon as diagnosed during the same admission electively.…”

Herniotomy and its outcome in congenital inguinal hernia at a tertiary care hospital: descriptive study

“…Ravikumar et al study done at Hubli, Karnataka in India have also highlighted that although routine inguinal hernia repairs in children are done on day care basis, however, in their study, majority of cases were treated on in-patient basis and hospitalization period was 1-6 days. 9 They expressed that this was due to the need of investigations and the lack of adequate anaesthesia related facilities and neonatal management facilities during the postoperative period. Majority of their patients were from remote village areas.…”

Management of Inguinal Hernia in Children

“…Although it is most frequently performed surgery in children. 9 Very few studies are available related to post operative complications internationally and in Pakistan. In this study 145 patients were male (80.5 %) and 35 patients (19.5 %) were female.…”