A Clinical Study and Management of Inguino-scrotal Swellings In Children

Aims and Objectives: To know the most common surgical problems in pediatric patients presented with inguino-scrotal swellings and management done routinely. Methodology: This study was carried out in the department of general surgery, Sharadaben hospital and pediatric surgery of VS hospital, Ahmedabad. The cases were studied for a period of about one year (January, 2017 to Dec, 2017) and all children below 12 years of age, presenting to us with inguinoscrotal swellings were included in this study. The information was analysed in terms of age, diagnosis, procedure carried out and outcome. Results: Amongst the 150 children under the age of 12 years, 143 patients were males and 7 were females. Among these 150, 52 cases were of hydrocoele, 70 cases of hernia (of which 63 were males and 7 were females), 25 cases of undescended testis and 3 cases of epididymo orchitis were documented. All cases underwent simple herniotomy for hernia and hydrocoele, orchidopexy for undescended testis. The length of hospital stay ranged from 2-4 days with mean of 2.46 days. 11 children in the study were documented to have short term complications, all of which were recognised in the hospital and managed with good results. Conclusion: Hernia and Hydrocoele in children are often congenital and diagnosed clinically (history and examination). Indirect inguinal hernia are more common than other groin hernias. Open herniotomy is the operation of choice for inguinal hernia in children.

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Modified Marcy repair for indirect inguinal hernia in children: a 24-year single-center experience of 6826 pediatric patients

Surgery Today ◽

10.1007/s00595-016-1352-2 ◽

2016 ◽

Vol 47 (1) ◽

pp. 108-113 ◽

Cited By ~ 11

Author(s):

Zenon Pogorelić ◽

Marijana Rikalo ◽

Miro Jukić ◽

Josip Katić ◽

Ivo Jurić ◽

...

Keyword(s):

Inguinal Hernia ◽

Pediatric Patients ◽

Indirect Inguinal Hernia ◽

Single Center ◽

Single Center Experience ◽

Marcy Repair ◽

Inguinal Hernia In Children

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Functional testicular torsion secondary to an incarcerated inguinal hernia in a 4-month old: complete recovery at 18-hours

Journal of Surgical Case Reports ◽

10.1093/jscr/rjab022 ◽

2021 ◽

Vol 2021 (2) ◽

Author(s):

Gregory M Taylor ◽

Christian C Strachan

Keyword(s):

Inguinal Hernia ◽

Testicular Torsion ◽

Pediatric Patients ◽

Complete Recovery ◽

Cord Compression ◽

Acute Scrotum ◽

Indirect Inguinal Hernia ◽

Incarcerated Inguinal Hernia ◽

Scrotal Swelling ◽

Urological Emergencies

Abstract One of the most common urological emergencies encountered in pediatric patients in the emergency department (ED) is the acute scrotum. We present the case of a 4-month-old male that presented to our community ED with scrotal swelling and vomiting of 16-hours duration. He was diagnosed with a functional testicular torsion from an incarcerated inguinal hernia, transferred to a hospital with pediatric urological capabilities and was taken to the operating room ~2 hours later. His hospital course was unremarkable, and he was discharged on day 3, having made a full recovery without any loss of bowel or testicle. There have only been a handful of cases in the literature of a pediatric patient presenting with a functional testicular torsion as a result of spermatic cord compression from an indirect inguinal hernia, with no reported cases of complete salvage at nearly 18 hours since symptom onset.

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The Incidence and Causes of Unplanned Reoperations as a Quality Indicator in Pediatric Surgery

Children ◽

10.3390/children9010106 ◽

2022 ◽

Vol 9 (1) ◽

pp. 106

Author(s):

Miro Jukić ◽

Ivona Biuk ◽

Zenon Pogorelić

Keyword(s):

Postoperative Period ◽

Quality Indicator ◽

Pediatric Surgery ◽

Pediatric Patients ◽

Length Of Hospital Stay ◽

Common Procedure ◽

Asa Score ◽

Primary Surgery ◽

Management Of Complications ◽

Duration Of Surgery

Background: Unplanned return to the operating room (uROR) within the 30-day postoperative period can be used as a quality indicator in pediatric surgery. The aim of this study was to investigate and evaluate uROR as a quality indicator. Methods: The case records of pediatric patients who underwent reoperation within the 30-day period after primary surgery, from 1 January 2018 to 31 December 2020 were retrospectively reviewed. The primary outcome of the study was the rate of uROR as a quality indicator in pediatric surgery. Secondary outcomes were indications for primary and secondary surgery, types and management of complications, factors that led to uROR, length of hospital stay, duration of surgery and anesthesia, and starting time of surgery. Results: A total of 3982 surgical procedures, under general anesthesia, were performed during the three-year study period (2018, n = 1432; 2019, n = 1435; 2020, n = 1115). Elective and emergency surgeries were performed in 3032 (76.1%) and 950 (23.9%) patients, respectively. During the study period 19 (0.5%) pediatric patients, with the median age of 11 years (IQR 3, 16), underwent uROR within the 30-day postoperative period. The uROR incidence was 6 (0.4%), 6 (0.4%), and 7 (0.6%) for years 2018, 2019, and 2020, respectively (p = 0.697). The incidence of uROR was significantly higher in males (n = 14; 73.7%) than in females (n = 5; 26.3%) (p = 0.002). The share of unplanned reoperations in studied period was 4.5 times higher in primarily emergency surgeries compared to primarily elective surgeries (p < 0.001). The difference in incidence was 0.9% (95% CI, 0.4–1.4). Out of children that underwent uROR within the 30-day period after elective procedures, 50% had American Society of Anesthesiologists (ASA) score three or higher (p = 0.016). The most common procedure which led to uROR was appendectomy (n = 5, 26.3%) while the errors in surgical technique were the most common cause for uROR (n = 11, 57.9%). Conclusion: Unplanned reoperations within the 30-day period after the initial surgical procedure can be a good quality indicator in pediatric surgery. Risk factors associated with uROR are emergency surgery, male gender, and ASA score ≥3 in elective pediatric surgery.

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Indirect Inguinal Hernia in Pediatric Patients

Journal of the Korean Association of Pediatric Surgeons ◽

10.13029/jkaps.2010.16.2.101 ◽

2010 ◽

Vol 16 (2) ◽

pp. 101 ◽

Cited By ~ 1

Author(s):

Sang Young Chung

Keyword(s):

Inguinal Hernia ◽

Pediatric Patients ◽

Indirect Inguinal Hernia

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Development and current status of treatment for pediatric indirect inguinal hernia

Medical Research ◽

10.6913/mrhk.202006_2(2).0001 ◽

2020 ◽

pp. 1-8

Author(s):

Zhifeng Mo ◽

Yuanfei Tan ◽

Hanzhong He ◽

Zhuorong Zhang ◽

Wenbin Yang

Keyword(s):

Inguinal Hernia ◽

Pediatric Surgery ◽

Current Status ◽

High Ligation ◽

Laparoscopic Technique ◽

Common Disease ◽

Indirect Inguinal Hernia ◽

Hernia Sac ◽

Inguinal Hernias ◽

Hernia Inguinal

To investigate the development and current status of the treatment of pediatric indirect inguinal hernia. Inguinal hernias include indirect hernias and direct inguinal hernias, but there are almost indirect inguinal hernias in children . Pediatric indirect inguinal hernia that the most common disease in pediatric surgery is almost caused by patent processus vaginali which incidence ranges from 0.8% to 4.4%.The treatment of pediatric indirect inguinal hernia reflects the process of pediatric surgery development, which from conservative non-surgical treatment to high ligation of the longitudinal incision hernia sac. In recent years, with the continuous improvement of medical level in China, laparoscopic technique has been applied in hospitals all over China, and laparoscopic high ligation of indirect inguinal hernia sac has become the standard for the treatment of pediatric indirect inguinal hernia.

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Triorchidism: presenting as undescended testis in a case of indirect inguinal hernia

Clinics and Practice ◽

10.4081/cp.2016.786 ◽

2016 ◽

Vol 6 (2) ◽

Author(s):

Ajay H. Bhandarwar ◽

Saurabh S. Gandhi ◽

Chintan B. Patel ◽

Amol N. Wagh ◽

Virendra Gawli ◽

...

Keyword(s):

Inguinal Hernia ◽

Undescended Testis ◽

Vas Deferens ◽

Recent Literature ◽

Sperm Count ◽

Semen Analysis ◽

Indirect Inguinal Hernia ◽

Left Testis ◽

Ectopic Testis

Triorchidism is the commonest variety of polyorchidism, an entity with more than two testis is an extremely rare congenital anomaly of the testis. Although excision of the abnormal testis is a safer alternative proposed, recent literature suggests more conservative approach in normal testes with watchful regular follow up to screen for malignancy. This case presented as a left inguinal swelling diagnosed as indirect left inguinal hernia. The left side testis was of smaller size (about half) with normal sperm count, morphology and motility. Intraoperatively indirect inguinal hernia was noted with supernumerary testis at deep ring in addition to normal left testis in left scrotal sac. The ectopic testis were small (2.5×2.5×1 cm) lacking epididymis and with short vas deferens. An evident normal semen analysis and varied anatomy, the decision for orchidectomy of ectopic testis was taken. The histopathological finding was consistent with arrest in germ cell development.

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Manual Reduction of Incarcerated Inguinal Hernia in Children

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v32i3.6146 ◽

2013 ◽

Vol 32 (3) ◽

pp. 229-232

Author(s):

Bijay Thapa ◽

Madhusudan Pun

Keyword(s):

Inguinal Hernia ◽

Indirect Inguinal Hernia ◽

Female Ratio ◽

Incarcerated Inguinal Hernia ◽

Manual Reduction ◽

Undergo Emergency Surgery ◽

Hands On ◽

Resection And Anastomosis ◽

Male To Female ◽

Inguinal Hernia In Children

Introduction: Incarceration of an indirect inguinal hernia in children is an acute emergency and one of the common complications that may occur before herniotomy. Inguinal hernias rarely go away, and therefore, virtually all should be repaired at any age of presentation. Incarcerated inguinal hernia can be reduced successfully by manual reduction if performed by experienced hands on time. The objective of this study was to assess the safety and efficacy of manual reduction of incarcerated indirect inguinal hernia. Materials and Methods: Thirty six patients who attended Emergency Department of Kanti Children’s Hospital over 30 months period from January 2009 to July 2011 were studied prospectively. All patients were diagnosed case of inguinal hernia and waiting for elective herniotomy. Results: There were 30(83.33%) males and 6(16.66%) females, with male-to-female ratio of 5:1. Right sided inguinal hernia was 20(55.5%) and left 16(44.44%). The ages ranged from 1.5 months to 28 months with mean age of 15 months. Time of incarceration ranged from 3 hours to 30 hours. Manual reduction was successful in 30(83.33%). Remaining six had to undergo emergency surgery. Four patients with edematous but viable hernial contents had successful surgical reduction. Two patients with gangrenous small bowel loops had bowel resection and anastomosis. Conclusion: Manual reduction is safe and effective when performed timely. Herniotomy should be done without delay once diagnosed to avoid unnecessary complications. DOI: http://dx.doi.org/10.3126/jnps.v32i3.6146 J. Nepal Paediatr. SocVol.32(3) 2012 229-232

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