Keywords
umbilical
linea alba
groin
inguinal
crural
abdominal wall
child
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Abstract
Introduction :
The management of congenital hernias of the anterior abdominal wall in children is a frequent surgical activity. The aim of this study was to examine the epidemiological, diagnostic and therapeutic aspects of abdominal wall hernias in children at Niamey National Hospital.
Materials and methods :
This was a cross-sectional study with retrospective and prospective data collection carried out in the general and visceral surgery departments of the Hôpital National de Niamey over a period of eighteen (18) months (September 1 to February 29, 2020). Cases of congenital hernias in children aged 0 to 15 years (0 to 180 months) were included. General anesthesia and herniorrhaphy were used in all patients.
Results :
Of a total of 1,060 hernias managed, 544 cases were in children aged 0 to 15 years (n=500), giving a hospital frequency of 51.32%. The median age was 48 months, with extremes of 2 and 180 months. In 75.2% (n=376) the age was ≤ 60 months. Males accounted for 72% of cases (n=360), i.e. a sex ratio of 2.57. Consanguinity was found in 17.6% of cases (n=88). Swelling and pain were the main reasons for consultation in 98.4% and 27.6% of cases respectively. According to location, umbilical hernia (HO) and inguinal hernia (HI) were found in 55.88% (n=304) and 37.32% (n=203) respectively. For HO, the arciform incision on the left was the approach used in 75.99% of cases (n=231). The inguinal incision at the lower abdominal fold was used for IH in 52.22% of cases (n=106). The contents of the hernia sac revealed viable omentum in 70.04% of cases (n=381), followed by viable intestine in 29.96% (n=163). Separate U-stitch herniorrhaphy was performed in 94.74% (n=288) of cases for HO. For HI and HC, the type of cure was dissection + ligation of the sac in 100% of cases. Average hospital stay was 4.62 days. Postoperative course was uncomplicated in 97.2% of patients (n=486). Complications occurred in 2.8% (n=14), classified as Clavien&Dindo grade I (n=6) and II (n=8).
Conclusion :
Congenital hernias of the anterior abdominal wall in children are a frequent pathology, dominated by groin and umbilical hernias. Treatment of simple hernias by herniorrhaphy gives good results and reduces the risk of strangulation, which can be serious.
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