Risk of incarceration of inguinal hernias among paediatric patients awaiting elective surgery at the University Teaching Hospital, Lusaka, Zambia

Abstract

Background: This study was conducted to determine our own institutional rate and risk of inguinal hernia incarceration among infants and children awaiting elective surgery. Inguinal hernias in infants and children are very common. One of their common complications before surgery is incarceration. Rate and risk of
incarceration among our patients awaiting surgical care was not known.

Method: A retrospective review of infants and children under the age of 17 years, who had undergone inguinal hernia repair or had incarcerated, from January 2015 to January 2017 was performed. Interviewer completed questionnaires were used to abstract data from the clinical records. A total of 364 patients were included
for analysis, in this study. Descriptive statistics, Regression Analysis and Kaplan Meiers Survival Analysis were employed.

Results: The infants and children were stratified into seven age groups. The overall incarceration rate was 13.45%. The risk of incarceration was age  dependent. It ranged from 0.52 daily risk of incarceration, among neonates, to zero daily risk of incarceration among older children. Longer wait times were associated with increased rate and risk of inguinal hernia incarceration.

Conclusion: The overall rate of incarceration was high (13.45%). Longer wait times, infants and younger children, male sex, right sided hernias were associated with unacceptably higher rates & risks. Neonates had as much as 5 times higher risk of incarceration than other children. The best time to operate is before 3 weeks for neonates, before 2 months for infants & before 4 months for younger children to prevent incarceration.