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Repair of incarcerated inguinal hernia in an infant with acute viral bronchiolitis

[La réparation d’une hernie inguinale incarcérée chez un enfant atteint d’une bronchiolite virale aiguë]

From the Division of Pediatric Anesthesia, Alberta Children’s Hospital, University of Calgary, Calgary, Alberta, Canada.

Address correspondence to: Dr. Robin G. Cox, Division of Pediatric Anesthesia, Alberta Children’s Hospital, 1820 Richmond Road S.W., Calgary, Alberta T2T 5C7, Canada. Phone: 403-943-7260; Fax: 403-943-7606; E-mail: robin.cox{at}calgaryhealthregion.ca

Purpose: To describe the anesthetic concerns and management options in an infant with acute viral bronchiolitis who required emergency surgery.

Clinical features: A 12-week-old infant presented to the emergency department with an incarcerated right inguinal hernia. The history was complicated by concurrent acute bronchiolitis. As the hernia was irreducible, emergency surgery was required. General endotracheal anesthesia, following a rapid sequence induction, was supplemented with a caudal epidural block. Inhaled salbutamol and suctioning for thick tracheal secretions were required and were found to be clinically useful. The baby made a good postoperative recovery.

Conclusions: A variety of techniques may be used to anesthetize the infant with concurrent acute bronchiolitis. In this case a good outcome was achieved with combined general and regional anesthesia, together with the use of inhaled salbutamol.