Inguinal hernia in children: and Indian experience

Abstract

In India, due to the limited pediatric surgical services available, the majority of the patients with indirect inguinal hernia (IIH) are managed by general surgeons. Between January 1986 and June 1992, at a tertiary care level center, 392 children with inguinal hernia were seen from 0–12 years of age (4.5% of all pediatric surgical procedures). Sixty-five percent of these presented when below 5 years of age. The majority of these (376, 96%) were boys. There were 212 (54%) right sided, 150 (38.3%) left sided and 30 (7.7%) bilateral hernias. Eighteen children (4.6%) presented with incarceration, and 6 of these required intestinal resections. The results following surgical repair were excellent. Contralateral exploration was reserved for babies under 6 months of age and girls (intersex disorders excluded). In a non-teaching hospital in Delhi inguinal hernias constituted 12.5% of all surgical procedures. Most of the children were over 1 year of age and only the symptomatic inguinal hernias were operated upon, without a policy for contralateral exploration. Due to the high risk of incarceration in premature babies, a careful search for the presence of inguinal hernia is recommended.