Musa S., 4

Musa is 4 year old boy is an orphan who lost his parents at a result of car accidents on there way to Damaturu he leaves with his grandfather at Gasma village. Musa persistent umbilical swelling of three months' duration, recently complicated by signs of strangulation and infection. ​The swelling has been present for approximately three months. Within the last two weeks, the hernia became irreducible (cannot be pushed back) and strangulated. The patient has experienced severe pain and vomiting. Interestingly, these symptoms are partially alleviated when the patient is in a lying-upright position. The intensity of the pain has significantly incapacitated the patient, preventing him from attending school, playing, or participating in family activities. On presentation at our facility, he was examined and diagnosed with a strangulated Hernia.

Musa was admitted as a case of strangulated left inguinoscrotal hernia requiring urgent surgical intervention. On arrival, he was stabilized with intravenous fluids (normal saline or Ringer’s lactate) to correct dehydration, and a nasogastric tube was inserted to relieve vomiting. Vital signs were closely monitored. He was started on intravenous antibiotics, including in Ceftriaxone and Metronidazole, alongside analgesics such as Paracetamol for pain control. After stabilization, he underwent emergency herniotomy and repair. The herniated bowel was assessed, found viable, reduced, and the defect repaired. Postoperatively, he was monitored for complications, continued on antibiotics, and gradually reintroduced to feeding. Musa improved steadily, with reduced pain and return of normal activity. With proper care and follow-up, full recovery is expected.

Musa’s presentation is consistent with a strangulated left inguinoscrotal hernia, a surgical emergency. The irreducible painful swelling with vomiting indicates compromised bowel and risk of ischemia. Immediate surgical intervention is required to prevent complications such as gangrene, perforation, peritonitis, and sepsis. The prognosis is good with prompt treatment, with expected full recovery and return to normal activities. However, delayed management may lead to serious complications and a guarded outcome.