Retrospective Analysis of Inguinal Hernia in Pediatric Patients in a Tertiary Center, Addis Ababa, Ethiopia

Abstract

Background: Inguinal hernia is one of the most frequent reasons for referral to the pediatric surgery unit. The incidence ranges from 1% to 5% in the pediatric population. Surgery for inguinal hernia is among the most commonly performed procedures, with good overall outcomes and few complications. Objective: The study aimed to evaluate the pattern and outcome of inguinal hernia surgery in children. Methodology: This retrospective 5-year cross-sectional study was conducted on all pediatric patients with inguinal hernia (age <13 years) operated on between September 1, 2014, and August 31, 2019, in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Results: The male to female ratio of inguinal hernia was 19:1. It was slightly more predominant on the right side and bilaterality occurred in about 10.6% of cases. The mean age at presentation was 15 months, and the average waiting time for patients to be operated on was 5 months. The overall incarceration and strangulation rates were 24% and 3.8%, respectively. Infants had a higher risk of incarceration/strangulation than other children. Among patients who underwent elective surgery, 63% (53/84) of operations were carried out as day-case surgery. The overall mortality, complication rate, and recurrence risk following surgery were 0.9%, 11.5%, and 9.6%, respectively. Bilaterality increased the occurrence of late postoperative complications. Conclusion: All inguinal hernia cases were indirect hernias operated on by standard open surgical techniques. Our study showed increased incarceration rates, recurrences, and complications after surgery. This is because of the delayed presentation of patients and delayed intervention for patients. Therefore, early and timely intervention with proper surgical techniques should always be considered.