Journal List > J Korean Surg Soc > v.80(2) > 1011242

Park, Jung, Park, and Choi: Clinical Analysis of Metachronous Inguinal Hernia in Children

Abstract

Purpose

The purpose of this study is to identify the incidence of metachronous contralateral inguinal hernia (MCH) and how early patients visit hospital upon discovering the presence of a lump on the contralateral side after initial hernia repair.

Methods

This is a retrospective study of 2,169 patients with inguinal hernia between January 2001 and January 2010 at a single institution. We evaluated the occurrence of MCH among 1,689 consecutive unilateral inguinal hernia (UIH) patients who were treated in our department. We also analyzed and compared the time lag (number of days) between noticing the presence of hernia and hospital visit between UIH and MCH.

Results

A total of 102 patients with MCH underwent initial UIH repair during the study period. The incidence of MCH was 6.0% and was slightly higher in males (6.7%) than in females (3.5%). The patients with left inguinal hernia (7.3%) had higher incidence of developing MCH than those with right (5.2%). When we analyzed the patients with MCH, 69.6% of them were under age 5 and 74.6% of MCH occurred within 2 years after initial UIH repair. Seventy-three percent of the patients with MCH, whose time lag was over one month when the first episode of UIH occurred, visited hospital later as MCH occurred.

Conclusion

The incidence of MCH within the study period is 6.0%. It is slightly higher in males and in patients with left inguinal hernia. Most MCH occurred under age 5 and within 2 years after initial UIH repair.

Figures and Tables

Fig. 1
Numbers and proportion of metachronous inguinal hernia (MCH) by age group. Note that the highest percentage of patients are preschool children (54.9%) and 69.6% of patients with MCH are under age 5.
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Fig. 2
Occurrence of MCH after initial repair. The numbers above each box indicate proportions and in the box show the number of patients. Note that 74.6% of MCH occurred within two years.
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Fig. 3
Time lag of hospital visit after notice of metachronous inguinal hernia compared to the first unilateral inguinal hernia. Amid 84 cases, 48.8% of patients visited earlier than the first event, whereas, 39% of them visitedlater. Patients who visited earlier at the first occurrence of unilateral inguinal hernia, with a history of less than 1 month, tend to visit earlier the second time (61%) and vice versa (73%).
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Table 1
Number of patients and incidence of metachronous contralateral inguinal hernia according to site (P=0.081)
jkss-80-142-i001

*Rt to Lt means left metachronous inguinal hernia after initial right hernia repair; Lt to Rt means right metachronous inguinal hernia after initial left hernia repair.

Table 2
Number and incidence of metachronous contralateral inguinal hernia by sex
jkss-80-142-i002

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