Hernia and Hydrocele
NEWBORN INGUINAL HERNIA - LEADING TO STRANGULATION AND PERFORATION
#TIME TO REFORM THE COUNSELLING #
PRESENTATION
Bulge in inguinal region / inguinoscrotal region/ Groin area/ Private Part.
INCIDENCE
4 % TERM AND 33% PRETERM NEWBORNS
TIMING OF SURGERY
AS SOON AS DIAGNOSED unless the baby has cardiopulmonary issue which needs optimization first. Cut off weight is 2 kg still the waiting is advisable with Hawk's eye vision.
COMPLICATION
A DAY CARE SURGERY TURNING TO DISASTER # INCREASED MORBIDITY AND IN WORST SCENARIO MORTALITY# WHEN ALL WE NEED IS "TO BECOME MORE AWARE AND ACTIVE -RATHER THAN A CASUAL COUNSELLING."
TODAY'S TIME WHEN WE HAVE AVAILABILITY OF NEONATAL SURGEON AND ANAESTHESIA JUST A TIMELY DIAGNOSIS AND PROPER COUNSELLING CAN CHANGE THE COURSE.
HOW???
Right information to the parents about the diagnosis....Inguinal Hernia needs surgical treatment and it never never never resolves itself. Explaining them about the danger signs so that they get timely help rather than complicating things more, which goes out of way.
A COMPLICATED HERNIA IS FAR TOO CHALLENGING FOR ANAESTHETIST TO HANDLE THE AIRWAY AND FOR SURGEON TO OPREATE BECAUSE OF LOSS OF ANATOMICAL PLANES AND THEREBY MORE RISK OF INJURY TO VAS AND VESSELS...AND THE SEPSIS CAUSES A TOPSY TURVY NICU stay. Sharing it for everyone's interest so that we become more vigilant in our counselling. "Decision is always in parents hand but doing our best with the best of our knowledge and skills is what we can offer."
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