Management of Incarcerated Inguinal Hernia in Children at the University Hospital of Antananarivo - Joseph Ravoahangy Andrianavalona
Article Main Content
Inguinal hernia is one of the most common surgical pathologies in children. The main risk is the evolution towards strangulation especially before the age of one year. Our study reports our experience on the management of strangulated hernias in children at the University Hospital Center of Antananarivo - Joseph Ravoahangy Andrianavalona (CHUA - JRA).
This is a 12-month retrospective study. The parameters studied are the age of onset of strangulation, gender, the side concerned, clinical manifestations, therapeutic methods, outcomes.
Of 74 cases collected, 96% were male. The right side predominated with 71.62% of cases. More than 70% of the cases were less than a year old, of which 50% were less than 3 months old. Besides the signs of strangulation, 10 cases presented an evident occlusive syndrome and 5 cases had come with a deterioration of the general state. Among 56 cases of initial reduction, 49 cases were reduced and their surgical treatment was postponed from 2 to 7 days. Cases with evident signs of complications, reduction failure, and cases of ovarian hernias had emergency surgery. Two cases of immediate post-operative death, 6 cases of testicular necrosis and two cases of recurrence over a three-month follow-up were deplored in patients operated on immediately.
In case of strangulated hernia, delayed surgery after an immediate reduction offers a better prognosis. The main factor limiting this method is the late consultation responsible for advanced visceral complications.
References
-
Aboagye J, Goldstein SD, Salazar JH, Papandria D, Okoye MT, Al’Omar K et al. Age at presentation of common pediatric surgical conditions : reexamining dogma. J Pediatr Surg. 2014; 49: 995-9.
Google Scholar
1
-
Clatworthy WH Jr, Thompson AG. Incarcerated and strangulated inguinal hernia in infants : a preventable risk. J Am Med Assoc. 1954; 154: 123-6.
Google Scholar
2
-
Stylianos S, Jacir NN, Harris BH. Incarceration of inguinal hernia in infants prior to elective repair. J Pediatr Surg. 1993; 28(4): 582-3.
Google Scholar
3
-
Rattin KN, Garg P. Neonatal scrotal fecal fistula. Pediatr Surg Int. 1998; 13: 440-44.
Google Scholar
4
-
Alrzoq RA, Alhaji AMA, Alolayt IYI, Almulhim AI, Althobaiti SA, Alzarhani IA et al. The incidence of inguinal hernia among children. The Egyptian Journal Of Hospital Medecine. 2018; 70(3): 483-6.
Google Scholar
5
-
Ein SH, Njere I, Ein A. Six thousand three hundred sixty-one pediatric inguinal hernias: a 35 year review. J Pediatr Surg. 2006; 41: 980-6.
Google Scholar
6
-
DeBoer A. Inguinal hernia in infants and children. AMA Arch Surg. 1957; 75: 920-8.
Google Scholar
7
-
Erdogan D, Karaman I, Aslan MK, Karaman A, Cavusoglu YH. Analysis of 3,776 pediatric inguinal hernia and hydrocele cases in a tertiary center. J Pediatr Surg. 2013; 48(8): 1767-72.
Google Scholar
8
-
Houben CH, Chan KV, Mou JW, Tam YH, Lee KH. Irreductible inguinal hernia in children : how serious is it ? J Pediatr Surg. 2015; 50(7): 1174-6.
Google Scholar
9
-
Lawal TA, Egbuchulem KI, Ajao AE. Obstructed inguinal hernia in children: case-controlled approach to evaluate the influence of socio-demographic variables. J West Afr Coll Surg. 2014; 4(2): 76-85.
Google Scholar
10
-
Rantomalala HYH, Andriamanarivo ML, Rasolonjatovo TY, Rakotoarisoa AJC, Rakotoarisoa B, Razafindramboa H, et al. Les hernies inguinales étranglées chez l’enfant. Arch Pédiatr. 2005; 12: 361-5. French.
Google Scholar
11
-
Ngom G, Fall M, Allumeti MD, Ndour O, Fall I, Ndoye M et al. Les hernies inguinales étranglées de l’enfant en milieu africain : à propos de 135 cas. Rev Trop Chir. 2009; 3: 13-16. French.
Google Scholar
12
-
Thapa B, Pun M. Manual reduction of incarcerated inguinal hernia in children. J Nepal Paediatr Soc. 2012; 32(3): 229-32.
Google Scholar
13
-
Mieret JC, Moyen E, Ondima I, Koutabe E, Mboutol MC, Moyen G. Hernies inguinales étranglées chez l’enfant au centre hospitalier et universitaire de Brazzaville. Rev Int Sc Méd-RISM. 2016; 18(2): 157-60. French.
Google Scholar
14
-
Abdulhai SA, Glenn IC, Ponsky TA. Incarcerated Pediatric Hernias. Surg Clin N Am. 2017; 97: 129-45.
Google Scholar
15
-
Zhou X, Peng L, Sha Y, Song D. Transumbilical endoscopic surgery for incarcerated inguinal hernias in infants and children. J Pediatr Surg. 2014; 49(1): 214-7.
Google Scholar
16
-
Chirdan LB, Uba AF, Iya D, Dakum NK. Spontaneous scrotal faecal fistula in a neonate: report of a case. Nigerian J Surg Research. 2004; 6: 59-60.
Google Scholar
17
Most read articles by the same author(s)
-
Aristide R. Raherison,
Lala R. C. Andriamanarivo,
Lantoniaina G. Mohsinaly,
Henriot Tsianoherana,
Mamy L. Andriamanarivo,
Etiology Of Neonatal Peritonitis Treated at The University Hospital Joseph Ravoahangy Andrianavalona, Antananarivo , European Journal of Medical and Health Sciences: Vol. 4 No. 3 (2022) -
Aristide R. Raherison,
Alyssa G. Ramamonjiharisoa,
Lala R. C. Andriamanarivo,
Francis A. Hunald,
Mamy L. Andriamanarivo,
Appendico-Cutaneous Fistula: Exceptional Complication of Abdominal Drainage , European Journal of Medical and Health Sciences: Vol. 4 No. 2 (2022) -
Aristide R. Raherison,
Lala R. C. Andriamanarivo,
Tahiry Randriamanantena,
John A. B. Razafindrabe,
Mamy L. Andriamanarivo,
Bilateral Isolated Transverse Facial Cleft Repaired by Straight Line Closure: About Two Cases , European Journal of Medical and Health Sciences: Vol. 4 No. 3 (2022) -
Aristide R. Raherison,
Ramahandry H. Rakotoarisoa,
Lantoniaina G. Mohsinaly,
Mamy L. Andriamanarivo,
A Case of Abdominal Cystic Lymphangioma Seen at The University Hospital of Antananarivo HJRA , European Journal of Medical and Health Sciences: Vol. 4 No. 2 (2022)





