Early versus delayed repair of reduced incarcerated inguinal hernias in the pediatric population.

This study concerns 183 pediatric patients (age range, 14 days to 10 years) who initially presented with incarcerated inguinal hernias. In all of them, initial conservative management to reduce the hernia was successful. This consisted of elevation of the lower half of body and sedation and/or gentle manual pressure. Thereafter, 75 of them had "early" operation (within 72 hours). Early surgery was not possible for the other 108 patients because of various reasons. These patients were discharged from the ward and were scheduled for "delayed" repair within 1 to 3 months. The complication rates were similar for the two groups, but 17 (15.7%) of the 108 patients in the delayed group had repeat incarceration, some of them more than once during the waiting period. Reincarceration occurred as early as 5 days and as late as 120 days after the initial discharge. The authors conclude that the results of delayed repair were unfavorably affected by the recurrent incarceration, and therefore all pediatric patients should have hernia repair within 5 days after the reduction of incarceration.