Inguinal hernia in girls: A retrospective analysis of over 1000 patients
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In brief
In brief
Retrospective study of 1,084 girls undergoing inguinal hernia repair found ovarian involvement in 21.7% of cases with 6% strangulation rate. Younger gestational age, higher birthweight, and emergency presentation were associated with increased strangulation risk, though optimal surgical timing remains unclear.
Written by the GCMD Library team from the article.
Background
In girls with inguinal hernia, timing of surgical repair to prevent ovarian strangulation and screening for Androgen Insensitivity Syndrome (AIS) remain controversial. This study assesses the incidence of ovarian strangulation and AIS, and its associated risk factors.
Methods
Electronic patient records were used to study girls aged 0–15 years who underwent inguinal hernia repair between 2000 and 2017. Patients with incomplete data were excluded. Risk factors were identified using logistic regression.
Results
This study includes 1084 girls (median (IQR) age: 133.5 (14–281) weeks) who underwent 1132 hernia repairs (1015 unilateral, 117 bilateral) within a median (IQR) time interval of 12 (6–23) days following diagnosis. Hernia sac intraoperatively contained ovary in 235 (21.7%) patients, ovary was strangulated in 14 (6%). Risk factors for ovarian strangulation were younger gestational age (OR 0.49), higher birthweight (OR 32.18), and first presentation at the emergency department (OR 13.07). However data were partly missing. Ectopic testis was found in seven (0.6%) patients. Metachronous contralateral inguinal hernia and ipsilateral recurrence developed in 6.1% and 0.3%, respectively.
Conclusions
Ovarian hernia was diagnosed in 21.7%, and ovary was strangulated in 6%. No definite conclusions can be drawn regarding risk factors for strangulation and timing of surgery in girls with irreducible ovarian hernia.
Level of Evidence
Level III.