INGUINAL HERNIOTOMY IN YOUNG INFANTS, WITH EMPHASIS ON PREMATURE NEONATES

Over a period of 6 years, 251 infants under 6 months of age underwent repair of inguinal hernias (IH; n = 311). There were 241 males and 10 females. incarceration occurred in 59 infants (24%), one of whom had b ilateral incarceration. As a result of the authors' policy to operate on infantile IH within 7 days of diagnosis, only 6% of the incarcerati ons occurred in already diagnosed cases. Sedation and taxis did not re duce the hernia in 22 cases (38%); transperitoneal closure of the inte rnal ring was performed in 14 of these. Eighty-nine infants (36%) were born premature; thirty-nine (41%) of these had been ventilated before , a possible cause of the hernia. Bilateral presentation was more comm on in the premature infants (35% v 17%); surprisingly, incarceration w as less common (13% v 24%). Hence, the policy of delaying herniotomy u ntil discharge from the neonatal unit was justified. During follow-up, six recurrences were noted and two cases of testicular atrophy. Copyr ight (C) 1994 by W.B. Saunders Company