What is the best management for an 8-year-old child with an inguinal hernia presenting with unbearable pain and vomiting?

Inguinal hernias can become incarcerated or strangulated when they become trapped or have their blood supply compromised, leading to severe complications. An 8-year-old child presenting with unbearable pain and vomiting is likely experiencing these complications. The acute presentation suggests that the hernia requires urgent intervention to prevent further complications such as bowel obstruction or necrosis.

Emergency herniotomy is the best management approach in this scenario. This surgical procedure promptly addresses the hernia, relieving pain and potentially preventing serious consequences due to strangulation. It is critical to address the underlying problem of the hernia immediately in a child who exhibits such alarming symptoms.

In contrast, other management options such as elective herniotomy, pain management, and supportive care are not appropriate in this acute situation, where timely intervention is necessary to mitigate risks of complications.