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Clinical and surgical aspects of strangulated umbilical hernias in children: a prospective study of 35 cases (Abstract)

Ngom G, Gassama F, Kane A, Seck M, Ndour O, Ndoye M
Department of Pediatric Surgery, Aristide Le Dantec Hospital
Dakar, Senegal

 

Abstract

Purpose: To report on clinical and surgical aspects of strangulated umbilical hernias in children in a developing country.
Patients and methods: A prospective study was conducted in the only Pediatric Surgery Department in Senegal from May 2006 to April 2009. Thirty five children, of whom 20 boys and 15 girls, with a mean age 34 months presented a strangulated umbilical hernia. We studied the clinical and surgical aspects among these children. The variables of interest were: time to admission, complains, clinical findings, contents of the hernial sac, diameter of umbilical defect, surgery performed and postopertaive outcomes. mean follow up time was 18 months. 
Results: Patients were admitted within 36 hours after the onset of symptoms. Complains were painful umbilical swelling (97.1%), vomiting (62.8%), occlusive syndrome (11.4%) and fever (2.9%). Physical examination revealed strangulated umbilical hernia in all cases, malnutrition in 40% of cases, dehydration in 20% of cases and peritonitis in 2.9% of cases. Viscera found in the hernial sac were small bowel (65.7%), omentum (22.9%) and the association of the two viscera ( 11.4%). The viscera were viable in 82.9% of cases and necrotic in 17.1% of cases. The diameter of the umbilical defect was medium size in 62.9% of cases and larger in 37.1% of cases. We noted a case of wound infection which was well managed with local treatment. There was no recurrence or death.
Conclusion: Children with strangulated umbilical hernia are received late in Senegal. This long admission’s delay explains the poor status of children and the frequency of necrosis. 
keywords: strangulated umbilical hernia, long admission’s delay, necrotic viscera

 

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