Management of Incarcerated Inguinal Hernia in Children at the University Hospital of Antananarivo - Joseph Ravoahangy Andrianavalona

Abstract

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.