Clinical Profile and Management of Inguinoscrotal Swellings in Paediatric Age Group

Abstract

Background: Inguinoscrotal swellings are one of the commonest surgical conditions among all age groups throughout the world. Among the Inguinoscrotal swellings, Inguinal hernia and Hydrocele top the list in frequency. They represent the conditions most frequently requiring surgical repair in all the age groups. Hernias and hydroceles are common conditions, and inguinal herniotomy is one of the most frequently performed surgeries. The diagnosis rests on clinical history as well as examination. If the diagnosis remains inconclusive then one can go for ultrasonography to confirm the diagnosis. Method: This is a Prospective and observational study was conducted in Department of General Surgery, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur.  All consecutive patients of the age of 14 years and below with inguinoscrotal swellings satisfying the pro forma were selected. All the selected patients 14 years and below including both male and female patients who presented with swelling in inguinoscrotal region admitted to Department of General Surgery, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur. Results and discussion: In this study of 100 children, 96 were males and 4 were females, the ratio was24:1. Our study was in accordance with all the other studies of inguinal hernia in children, wherein male preponderance was noted. In my study the predominance of involvement of Right side in inguinal hernia in pediatric age group was established with 60 (60%) occurring on Right Side, Left Side 32 (32%) and Bilateral 8 (8%). In 94 cases, 6 cases (6%) were diagnosed by US as CPPV. Out of 6 cases, 4 were on right side, 2 one left and all were boys and all are below 2 years. There were 6 cases of encysted hydrocele of the cord, 4 were on the left side and 2 on the right side. There were 8 cases of undescended testis, 4 cases were on the left side and 4 cases were on the right, allocated in the inguinal pouch. Of the total 100 patients, 2 patient (2%) underwent MitchellBanks Surgery and Ferguson technique was done for 98 patients (98%). Conclusion: In the case of undescended testis, orchidopexy should be done at the time of hernia repair. There is no consensus on when or if contralateral inguinal exploration is necessary. A contralateral exploration was not done in our patients as they were not symptomatic and to avoid prolongation of operative time and complications. Postoperative complications are usually rare following elective operation. Recurrence is usually rare if operated by experienced surgeons. Inguinal herniotomy in children is a safe and effective operation.