Preoperative Nutrition in a Malnourished Child with Cryptorchidism and Irreducible Inguinal Hernia: Case Report

Abstract

The management of irreducible inguinal hernia with cryptorchidism is complicated by malnutrition, creating a "surgical-nutritional paradox" where surgical urgency conflicts with metabolic fragility. This case report elucidates the integrated nutritional management of a 10-year-old male presenting with an undescended testis, incarcerated hernia, and wasting. Methods: Utilizing the standardized Nutrition Care Process Terminology, a 72-hour preoperative "metabolic priming" strategy was implemented. This involved a High-Energy High-Protein (HEHP) diet synergized with Metamizole for pain and Dexamethasone for appetite stimulation to maintain the oral route. The intervention reversed the "Pain-Anorexia Cycle," increasing oral intake from a 52.3% deficit to 115.5% hyper-alimentation within three days. This optimization replenished glycogen stores, allowing for successful orchidopexy and herniotomy without complications. Short-term, aggressive preoperative nutritional support serves as a vital therapeutic bridge in hemodynamically stable patients, challenging the dogma of immediate incision.