INGUINAL HERNIOTOMY IN CHILDREN

Objective: To analyze 888 inguinal herniotomies in children. Methods: Retrospective analysis of all inguinal herniotomies performed over a p eriod of 7 years for children up to the age of 12 years in Qatif Centr al Hospital. Results: Eight hundred and eighty eight inguinal hernioto mies were performed for 742 children (643 males and 99 females) up to the age of 12 years. Of the 742 children, 397 hernias were on the righ t side, 199 on the left and 146 bilateral. Sixty-four (8.6%) children were emergencies with irreducible inguinal hernias. Irreducibility was more common in males than females, more common in right inguinal hern ia and increased in frequency of younger children. Forty four of the 6 4 with irreducible inguinal hernia were seen for the first time. Ninet y four percent of those presenting with irreducible inguinal hernia ha d their hernias reduced conservatively. There were 19 recurrences givi ng a recurrence rate of 21%. Conclusion: Inguinal herniotomy is the mo st common operation for infants and children worldwide. To obviate irr educibility and strangulation, early diagnosis and early referral for surgery is advocated. Irreducibility is more common in males, more com mon in right sided hernias and is increased in frequency of younger ch ildren. The majority of those who present with irreducible hernia, wit hout signs of strangulation, reduce conservatively, therefore an initi al conservative approach is advocated. Recurrence can be decreased by careful and meticulous dissection of their hernial sac and ligation hi gh up at the internal ring.