complications

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  • 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

Reference:

  1. Niedzielski J et al. Could incarceration of inguinal hernia in children be prevented? . Med Sci Monit. 2003 Jan;9(1):CR16-8

Last reviewed 01/2018