Document Detail

Inguinal hernias associated with biliary atresia.
MedLine Citation:
PMID:  22517517     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Infants with biliary atresia (BA) develop a degree of hepatic fibrosis as a consequence of their cholangiopathy. Some of them present clinically evident ascites that might predispose to inguinal hernias. We aimed to investigate whether infants with BA have a higher incidence of inguinal hernias.
METHODS: Single-center retrospective review of all BA infants diagnosed between January 2006 and December 2010. Infants with a clinical diagnosis of inguinal hernia were identified and compared with those without. Data were expressed as median (range) and compared with nonparametric statistical tests. p ≤ 0.05 was regarded as significant.
RESULTS: A total of 123 infants underwent Kasai portoenterostomy (KP) during the period. Of these, 10 (8.1%) infants (7 boys) developed inguinal hernias (bilateral n = 4, right n = 5, left n = 1); 9 were repaired (at KP [n = 3] and post-KP [n = 6] at 15 [7 to 30] days) using nonabsorbable sutures, and 1 died before repair. There was no difference in median age at KP (66 vs. 58 days, p = 0.31); cytomegalovirus (IgM positive) status (p = 1.0); use of postoperative corticosteroids (p = 0.49); or ultimate need for liver transplant (p = 1.0). However, aspartate aminotransferase-to-platelet ratio (surrogate marker of liver fibrosis) was higher in hernia infants (2.0 vs. 1.0; p = 0.02). Recurrence has not been identified at a follow-up of 27 months (4 to 55).
CONCLUSIONS: This is the first report to suggest that BA infants have a high incidence of inguinal hernias, which seems related to degree of liver fibrosis at presentation and presumably degree of ascites and increased intra-abdominal pressure.
Augusto Zani; Mark Davenport
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Publication Detail:
Type:  Journal Article     Date:  2012-04-19
Journal Detail:
Title:  European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie     Volume:  22     ISSN:  1439-359X     ISO Abbreviation:  Eur J Pediatr Surg     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-20     Completed Date:  2012-09-19     Revised Date:  2013-01-30    
Medline Journal Info:
Nlm Unique ID:  9105263     Medline TA:  Eur J Pediatr Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  117-20     Citation Subset:  IM    
Copyright Information:
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Department of Paediatric Surgery, King's College Hospital, London, United Kingdom.
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MeSH Terms
Ascites / complications
Biliary Atresia / complications*
Hernia, Inguinal / diagnosis,  etiology*
Liver Cirrhosis / complications
Portoenterostomy, Hepatic
Retrospective Studies
Comment In:
Eur J Pediatr Surg. 2012 Dec;22(6):488; author's reply p.489   [PMID:  23165512 ]

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