Clinical and Therapeutic Aspects of Inguinal Hernia in Children in the General Surgery Department of Reference Health Center in Commune I of Bamako Mali
Inguinal hernia in children is a congenital
pathology in children linked to the persistence of the peritoneo-vaginal canal
in children and the NüCK canal in girls; persisting into adulthood. This work
aimed to study inguinal hernia in children in the general surgery department of
the Reference Health Center of Commune I of the Bamako District; to determine
the frequency of inguinal hernia; describe the epidemiological, clinical and
therapeutic aspects of inguinal hernias and
in order to evaluate the cost of treatment. This was a prospective study from
April 2017 to March 2018 during which 60 children with an inguinal hernia were
collected. Inguinal hernias in children represented 9.23% of patients
operated on in the department. The average age was 59.23 months with extremes
of one month and 180 months and a standard deviation of 49.23 years. The male
sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was
found in 11.7% and was associated with a testicle not in place in 1.7% of
cases. 41.7% of our patients were referred by a doctor and 66.7% of patients
presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was
discovered before one week of life in 50% of cases. Inguinal swelling was
absent in 11.7% but observed intraoperatively. The inguinal hernia was
unilateral in 91.7% of cases and 70% of hernias were discovered by the parents
during pushing efforts. The inguinal hernia was located on the right in 61.7%
of cases. The hernia swelling was soft, painless, impulsive and reducible in
78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia
was simple in 95% of patients and hernial strangulation was observed in 3 cases
or 5% of cases. 98.3% of patients were ASA I. The treatment was carried out
openly in all our patients including closure of the vaginal peritoneal canal in
95% of cases under general anesthesia in
98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of
cases and hematoma: 1.7%). The immediate consequences were simple in 96.6% of
cases. No cases of recurrence occurred during the 6 months after the
intervention. The average cost of care was estimated at 69,743
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