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Inguinal Hernia in Children

What is an inguinal hernia?

A hernia occurs when a part of the intestine pushes through a weakness in the belly (abdominal) muscles. A soft bulge is seen underneath the skin where the hernia has occurred. A hernia in the groin area is called an inguinal hernia.

Illustration of  an inguinal hernia
Click Image to Enlarge

What causes an inguinal hernia?

A hernia can develop in the first few months after a baby is born because of a weakness in the abdomen muscles.

As a male baby grows and matures during pregnancy, the testicles develop in the abdomen. Then they move down into the scrotum through an area called the inguinal canal. Shortly after the baby is born, the inguinal canal closes. This stops the testicles from moving back into the abdomen. If this area does not close off completely, a part of the intestine can move into the inguinal canal through the weakened area of the lower belly wall. This causes a hernia.

In some cases, the part of intestine that pushes through a hernia may become stuck. It is no longer reducible. This means it can’t be gently pushed back into the belly. When this happens, that part of the intestine may lose its blood supply. A good blood supply is needed for the intestine to be healthy and work properly.

Girls don’t have testicles, but they do have an inguinal canal. So they can also have hernias in this area.

Who is at risk for developing a hernia?

Hernias occur more often in children who have 1 or more of the following risk factors:

  • A parent or sibling who had a hernia as an infant

  • Cystic fibrosis

  • Developmental dysplasia of the hip

  • Undescended testes

  • Abnormalities of the urethra

Inguinal hernias

Inguinal hernias occur:

  • In 1% to 5% of full-term babies

  • In 9 % to 11 % of babies born early (premature babies)

  • In children with a family history of inguinal hernias

  • More often in babies and children with other urogenital anomalies

  • More often in the right groin area than the left, but can occur on both sides

What are the symptoms of an inguinal hernia?

Hernias usually occur in newborns, but may not be noticeable for several weeks or months after birth. Straining and crying do not cause hernias; however, the increased pressure in the abdomen can make a hernia more noticeable.

Inguinal hernias appear as a bulge or swelling in the groin or scrotum. The swelling may be more noticeable when the baby cries, and may get smaller or go away when the baby relaxes. If your doctor pushes gently on this bulge when the child is calm and lying down, it will usually get smaller or go back into the abdomen.

If the hernia is not reducible, then the loop of intestine may be caught in the weakened area of abdominal muscle. The following are the most common symptoms that indicate this has occurred. However, each child may experience symptoms differently. Symptoms may include:

  • A full, round abdomen

  • Vomiting

  • Pain or fussiness

  • Redness or discoloration

  • Fever

The symptoms of an inguinal hernia may resemble other conditions or medical problems. Always consult your child's doctor for a diagnosis.

How is an inguinal hernia diagnosed?

Hernias can be diagnosed by a physical examination by your child's doctor. Your child will be examined to determine if the hernia is reducible (can be pushed back into the abdominal cavity) or not.

What is the treatment for inguinal hernias?

Specific treatment for an inguinal hernia will be determined by your child's doctor based on:

  • Your child's age, overall health, and medical history

  • The type of hernia

  • Whether the hernia is reducible (can be pushed back into the abdominal cavity) or not

  • Your child's tolerance for specific medications, procedures, or therapies

  • Your opinion or preference

An operation is necessary to treat an inguinal hernia. It will be surgically repaired fairly soon after it is discovered, since the intestine can become stuck in the inguinal canal. When this happens, the blood supply to the intestine can be cut off, and the intestine can become damaged. Inguinal hernia surgery is usually performed before this damage can occur.

During a hernia operation, your child will be placed under anesthesia. A small incision is made in the area of the hernia. The loop of intestine is placed back into the abdominal cavity. The muscles are then stitched together. Sometimes, a piece of meshed material is used to help strengthen the area where the muscles are repaired.

What is the long-term outlook for an inguinal hernia?

Once the hernia is closed, either spontaneously or by surgery, it is unlikely that it will reoccur. Reoccurrence of the hernia happens slightly more frequently if the intestine was damaged.

What are the symptoms of an inguinal hernia?

Hernias usually occur in newborns. But they may not be noticeable for a few weeks or months after birth. Straining and crying don’t cause hernias. But the increased pressure in the belly can make a hernia more easily seen.

Inguinal hernias appear as a bulge or swelling in the groin or scrotum. The swelling may be more easily seen when the baby cries. It may get smaller or go away when the baby relaxes. If your child’s healthcare provider pushes gently on this bulge when the child is calm and lying down, it will usually get smaller or go back into the belly.

If the hernia can’t be pushed back into the belly, then the loop of intestine may be stuck in the weakened area of abdominal muscle. The following are the most common symptoms that mean this has occurred. However, each child’s symptoms may vary. Symptoms may include:

  • A full, round belly

  • Vomiting

  • Pain or fussiness

  • Redness or discoloration

  • Fever

The symptoms of an inguinal hernia may look like other conditions or medical problems. Always see your child's healthcare provider for a diagnosis.

How is an inguinal hernia diagnosed?

To diagnose a hernia, your child’s healthcare provider will do a physical exam. Your child will be examined to determine if the hernia is reducible (can be pushed back into the abdominal cavity) or not.

How is an inguinal hernia treated?

Your child's healthcare provider will figure out the best treatment plan for your child based on:

  • Your child’s age, overall health, and medical history

  • How sick your child is

  • The type of hernia your child has

  • Whether the hernia can be pushed back into the abdominal cavity (is reducible) or not

  • How well your child handles certain medicines, treatments, or therapies

  • If your child’s condition is expected to get worse

  • The opinion of the healthcare providers involved in your child's care

  • Your opinion and preference

Surgery is needed to treat an inguinal hernia. The surgery will happen fairly soon after the hernia is discovered. That’s because the intestine can become stuck in the inguinal canal. When this happens, the blood supply to the intestine can be cut off, and the intestine can become damaged. Surgery is usually done before this damage can occur.

During hernia surgery, your child will be given medicine to put him or her to sleep (anesthesia). A small cut (incision) is made in the area of the hernia. The loop of intestine is placed back into the abdominal cavity. The muscles are then stitched together. Sometimes, a piece of mesh material is used to help strengthen the area where the muscles are repaired.

Once the hernia is closed (either on its own or by surgery), it is not likely that it will reoccur. A hernia will reoccur slightly more often if the intestine was damaged.

Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Online Medical Reviewer: Lehrer, Jenifer, MD
Date Last Reviewed: 10/1/2016
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