Inguinal hernia in Nigerian female children: beware of ovary and fallopian tube as contents

Abstract

Background: The risk of injury to the ovary and fallopian tube during herniotomy in female children is quite high, and reports on the frequency of these organs as inguinal hernia contents and, as such, prevention from injuries are not available in this subregion. This study was designed to determine the frequency of ovary and fallopian tube as contents of inguinal hernias sacs in Nigerian female children.

Methods: An eight-year prospective study was undertaken at two Nigerian healthcare institutions between July 2000 and June 2008. All female children treated with herniotomy during the period had their hernia sacs opened and inspected for their contents, which were documented on a pro forma.

Results: A total of 138 female children aged between 2 months and 12 years (mean 5 +/- 3.4 years) were diagnosed with 176 inguinal hernias treated with herniotomy at the two centers and comprised 11.1% of children with hernias in eight years. On inspection, 145 (82.4%) hernias contained either ovary and/or fallopian tube, with the ovary being the only content in 82 (46.6%) sacs. The ovary and fallopian tube were the contents in 43 (24.4%), while fallopian tube alone was the content in 20 (11.5%) hernias. It was only in 31 (17.6%) that they were not contents of the hernia sacs, as 21 (11.9%) of these hernias contained peritoneal fluid, seven (3.9%) omentum, and three (1.7%) loop of bowels. In the majority of children below the age of 5 years and in eight (4.5%) older children, the hernias were sliding, with ovaries forming part of the inferomedial wall with a high probability of injury during herniotomy.

Conclusion: Ovary and fallopian tube were common contents of inguinal hernia sacs in Nigerian female children. Efforts should be made to inspect the contents of hernia sacs during herniotomy, while blind transfixion without first opening them to inspect and reduce the contents should be avoided.