Emergency room reduction of incarcerated inguinal hernia in infants: is routine hospital admission necessary?

We studied the outcome in 94 infants less than 1 year of age who had an incarcerated inguinal hernia reduced in the emergency room. Fifty-six were admitted and 38 were sent home. Of the 56 infants admitted, 12 (21%) reincarcerated prior to surgery, whereas 28 (74%) of the 38 sent home reincarcerated. The incidence of reincarcinated was not affected by age or weight. Mean time to surgery was 2 days in the admission group and 10 days in the outpatient group. The cumulative reincarceration rate 72 h after the initial reduction was similar in the two groups, and the majority of reincarcerations in those sent home occured later than 72 h after the initial reduction. The wound infection rate was slighty higher in the admission group, but other early and late complications were not affected by either admission or the presence of reincarceration. Although it is safe to send infants home after emergency room reduction of an incarcerated inguinal hernia, definitive repair should be done within 72 h to avoid an increased risk of reincarceration.