Pediatric Inguinal Hernia
Inguinal hernias in children occur when the pathway from the abdomen to the scrotum or labia does not close.
- In boys, the testicles develop in the abdomen and then travel through this pathway into the scrotum.
- In girls, the round ligament of the uterus follows the same path.
When the pathway fails to close, there is a persistent communication between the abdomen and scrotum or labia. Abdominal contents (most commonly intestine or an ovary) can then slide in and out of this pathway and this is called a hernia. When fluid is contained in the hernia sac within the scrotum, it is called a hydrocele.
Children are move likely to develop a hernia for any of the following reasons:
- African-American descent (higher risk for umbilical hernias)
- Cystic fibrosis
- Developmental dysplasia of the hip (DDH, instability of the hip joint)
- Genital and urinary abnormalities
- Sibling or parent had a hernia as an infant
- Undescended testes
Most umbilical hernias do not cause symptoms and will resolve on their own by the age of 5 years. Symptoms for a hernia can include the following:
- Abdominal pain
- Belly button sticks out (umbilical hernia only)
- Discomfort in the groin, especially when bending, coughing or lifting
- Noticeable bulge in the stomach, scrotum or pubic bone
- Pain in the groin region
- Pressure or “heavy” feeling in groin (often described as something is pulling on the groin)
- Swelling in the testicles
Ultrasound is rarely required. These hernias do not go away on their own and require surgery to prevent complications such as the bowel getting stuck in the hernia sac. Depending on your surgeon, the procedure can be performed through a small incision in the groin or by using the laparoscope (minimally invasive surgery).
Depending on the age of your child, some surgeons may recommend looking for a hernia on the other side at the same time as the initial hernia surgery. The most common complications are wound infections and recurrence of the hernia which occurs approximately 2% of the time.