if the bowel becomes stuck inside the hernial sac (incarcerated), vascular compromise to both the bowel and testis may occur, requiring urgent intervention
untreated, incarcerated inguinal hernia can lead to atrophy of the testis, bowel necrosis and perforation and subsequent death of the infant
an inguinal hernia does not resolve spontaneously and must be repaired surgically because of the high risk of incarceration
unfortunately, some children develop an incarcerated hernia while awaiting a scheduled operation, or even prior to diagnosis
there is controversy regarding the best timing for hernia repair, and the practice of delaying surgery in infants is still common
delaying of operative intervention ncreases the risk of incarceration
incidence of incarceration ranges from 9% to 31%, and the majority of cases occur in children under 1 year of age
in one study (1), 9.7% of the children presented with incarcerated hernia, and 53% of all incarcerations occurred in children under 1 year of age. More than half of them (52.9%) were of those children who were known to have inguinal hernia prior to incarceration
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