Prognostic factors in childhood inguinal hernia at Wesley Guild Hospital, Ilesa, Nigeria.

OBJECTIVE

To determine the pattern, outcome and the prognostic factors in childhood inguinal hernia.

METHODS

A five-year prospective study.

METHODS

Wesley Guild Hospital, Ilesa, Nigeria.

RESULTS

Two hundred and eight patients presented with 237 inguinal or inguinoscrotal hernias. Seventy one per cent were aged five years and below and 24% were infants. Male patients accounted for 94.7% of the cases. Mean duration of symptoms was 1.2 years in the patients without hernia complication but less than five months in complicated hernia. Symptoms of complication such as vomiting and abdominal pain occurred in 7.8% to 15% of children mainly under five years. Inguinoscrotal hernia was diagnosed in 76.5% of cases, of whom 53.8% presented on the right side, 32.3% on the left and 14% bilaterally. Undescended testes, low birthweight, anaemia and malnutrition presented in 22.6% of the cases. Incarcerated hernia was diagnosed in 16 patients (7.7%), all males, with ages ranging from two weeks to two years. Eighty nine per cent of the patients were operated upon as outpatients. Undescended testes constituted the commonest associated operative finding in about five per cent of the patients and one patient had non-rotation of the gut involved in strangulation. Statistical analysis showed that clinical pattern, outcome and the incidence of postoperative complication were significantly dependent on the sex, age and presence hernia complications.

CONCLUSIONS

Inguinoscrotal hernia is commoner and predominantly in the male, majority of whom were below the age of five years. Most associated clinical and operative findings occurred in infants. Incarceration occurred more significantly in infants. Wound infection was the commonest complication. This and other complications were significantly affected by the age of the patients and incarceration.