Spectrum Of Hernias Among Children on The Plateau

Introduction: Hernia is one of the commonest congenital presentations to paediatric surgical clinics worldwide. Most literatures on paediatric hernias discuss mainly inguinal hernias as paediatric hernias, however just like in adults, the spectrum of paediatric hernias spans beyond the groin, to include the entire abdominal wall hernias and internal hernias. Objective: This study aimed to describe the epidemiology of hernias in children on the plateau, highlighting its prevalence, management and outcomes. Methods:This was a retrospective study where we analysed the medical records of children aged 0-17 years with hernias from 2017 to 2024. Data were obtained from2 types of data sets.1. hospital based patients records and 2. Community base medical records of children obtained during free medical outreaches in the 3 senatorial zones of plateau state Results: A total of 589 patients’ cases were reviewed, 437 males and 152 females with a male to female ratio of 2.8:1. The Mean age was 80 months. Types of hernia: 331(56,2%) had inguinal hernia,207(35.1%) umbilical, 28(4.8%) paraumbilical, 11(1.9%) ventral, 5 (0.8%) epigastric, 4 (0.7 %) incisional hernia, 2 (0.3) congenital diaphragmatic (CDH) and 1 (0.2%) Transmesenteric hernias. There were 61(11.6%) cases of synchronous hernias. Presentation: 559 (94.9%) were elective and 30 (5.1%) emergencies (incarceration 24,4.1%, obstruction 2, 0.3% and strangulation 4, 0.7%). Type of surgery performed: 360(58.0%) herniotomies, 253 (40.7%) herniorrhaphies and 8(1.3%) hernioplasties (Note: some patients had multiple hernias, more than 1 procedure). Complications: 19(3.1%) had complications recorded in 15 patients (9, 1.5% wound infection, 5, 0.8% recurrence, 3, 0.5% acquired undescended testis and 2, 0.3% testicular atrophies). Conclusion: Hernia is prevalent in children on the plateau. Its surgery is relatively safe with low complication rate in our environment, despite not being able to assess data on the level of competences of those who performed these procedures outside the tertiary hospitals. Training of medical officers at nontertiary institutions could provide accessible safe surgical care, improve outcome and further reduce this complication rate.