OBSTRUCTED INGUINAL HERNIA IN CHILDREN: CASE-CONTROLLED APPROACH TO EVALUATE THE INFLUENCE OF SOCIO-DEMOGRAPHIC VARIABLES
Lawal TA, Egbuchulem KI, Ajao AE
*Correspondence
Grant support: None
Conflict of interest: None
ABSTRACT
Background: Obstructed inguinal hernia in children is associated with high morbidity in developing countries due to delay in accessing care. Attempts made to reduce waiting time to herniotomy are not backed by a predictive model of disease occurrence and modeling obstructed inguinal hernia implies knowledge of factors associated with this complication. Aim & Objectives: To determine the relationship between socio-demographic variables and obstructed inguinal hernia in children. Design: Case controlled
Setting: Paediatric surgery unit of a tertiary hospital Materials & Methods: The study was prospective – all children presenting with obstructed inguinal hernia at University College Hospital, Ibadan, Nigeria between May 2009 and April 2014 were studied. For each case, two children with non-obstructed inguinal hernia were recruited consecutively as controls. Their demographics, clinical features, management and outcomes were obtained including the socio-demographic attributes of the parents. The data obtained were computed using SPSS; the p-value for significance was set at < 0.05.
Results: A total of 81 consecutive patients (27 with obstructed inguinal hernia and 54 with non-obstructed inguinal hernia) were studied; they were aged between 2 weeks and 13 years with a mean of 25.9 ± 3.8 months. There were no differences between cases and controls based on gender, parents’ religion, tribe, social status and side affected (p > 0.05). The mean age at presentation was 13.7 ± 5.6 months in the obstructed inguinal hernia vs. 32.0 ± 4.8 months in the non-obstructed inguinal hernia groups (p = 0.016). The duration of groin swelling before presentation was not significantly different (30.0 ± 7.7 vs. 28.3 ± 6.4 months, p = 0.893). Infants were three times more likely than older children to develop obstruction (OR = 3.33, CI: 1.20, 9.09, p = 0.020).
Conclusion: The age at presentation is the significant socio-demographic variable in this study that could predict obstruction in healthy children with inguinal hernia delivered at term.
Key words: Obstructed inguinal hernia, Children, Predictive factors, Nigeria.