Inguinal hernia in infants and children

: Inguinal hernia is a rather common pathology encountered in children, present in 1 to 3% of full term newborns and in 3 to 5% of premature babies. Between January 1982 and January 1983, we operated upon 134 children with inguinal hernia, more than half of them were under 6 months of age. In most cases, the history of the patient would suffice to make the diagnosis, indeed, in 99 cases, the history would reveal the transient presence of an inguinal mass often absent during the examination at the clinics. In every other case we palpated an inguinal mass. Among these, 15 cases of indirect inguinal hernia were found, 4 were spontaneously reduced by soft manipulations, 10 were reduced under premedication and only one was irreducible. The other cases of irreducible inguinal mass appeared to be hydrocele and cysts of the cord. All our patients were in a good state of health, but one child suffering from a strangulated inguinal hernia causing intestinal obstruction. He was the only one to undergo an emergency operation, the others were operated upon within 24 to 72 hours after reduction of the mass. No relapse was ever observed. We advocate systematic surgery for any diagnosed hernia. The surgical treatment consists in the closing of the peritoneal vaginal duct. This operation is to be performed regardless of the child's age, height or weight and therefore avoiding complications a strangulated irreducible inguinal hernia would bring. Optimal operation conditions are gathered in a paediatric surgery unit where one is used to the anesthesia and to the delicate postoperative supervision of very young children.