TY - JOUR
T1 - Inguinal hernia in girls
T2 - A retrospective analysis of over 1000 patients
AU - Dreuning, Kelly MA
AU - Barendsen, Rinse W.
AU - van Trotsenburg, AS Paul
AU - Twisk, Jos WR
AU - Sleeboom, Christien
AU - van Heurn, LW Ernest
AU - Derikx, Joep PM
PY - 2020/9
Y1 - 2020/9
N2 - 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.
AB - 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.
KW - Androgen insensitivity syndrome
KW - Girls
KW - Hernia repair
KW - Inguinal hernia
KW - Ovary
KW - Strangulation
UR - http://www.scopus.com/inward/record.url?scp=85083301476&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jpedsurg.2020.03.015
DO - https://doi.org/10.1016/j.jpedsurg.2020.03.015
M3 - Article
C2 - 32317102
SN - 0022-3468
VL - 55
SP - 1908
EP - 1913
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 9
ER -