In this section
A hernia happens when part of an internal organ (usually the bowel) pushes through a weak spot in the muscles covering the abdomen (tummy). Hernias show up as a lump or bulge under the skin.
An inguinal (in-gwin-al) hernia is a hernia that occurs in the groin. In boys, an inguinal hernia may extend into the scrotum (pouch of skin containing the testes). Boys are up to eight times more likely than girls to have an inguinal hernia.
A doctor should always see your child for a hernia diagnosis. In some cases, inguinal hernias can become life-threatening, and require urgent medical attention.
If your child has an inguinal hernia, they may have swelling or a visible lump in the groin, or a swelling in the scrotum. The swelling:
Inguinal hernias are slightly more common on the right side, but may occur on the left or on both sides of the groin or scrotum.
In a simple inguinal hernia, the bowel can move freely in and out of the opening in the muscle wall. This is described as being reducible.
Sometimes there are inguinal hernia complications. If part of the bowel gets stuck outside the muscle wall, it is at risk of having its blood supply cut off. This is then no longer reducible and is described as a strangulated hernia, which requires urgent medical attention.
You should call an ambulance if your child has an inguinal hernia and they develop any of the following symptoms:
If you think your child has a hernia of any kind, you need to see a GP. The GP will examine your child's groin on both sides. The examination may include feeling the hernia and attempting to reduce it. If the hernia is not visible at the time of the visit, your doctor may try to bring it
out by pressing lightly on your child's abdomen.
If your child shows signs of a strangulated hernia, they need urgent surgical treatment at a specialist paediatric hospital.
Surgical hernia repair (a herniotomy) is always necessary in cases of inguinal hernia – even simple inguinal hernias are at risk of becoming strangulated. A herniotomy will prevent the hernia from coming back. If the inguinal hernia is detected and corrected early, there should be no long-term
Hernia surgery is done under anaesthesia. Anaesthetic may be either general (where your child will be asleep), or spinal (where your child will be completely numb from the chest down during the operation). The type of anaesthetic used depends on the child and will be discussed with you.
If your child has an inguinal hernia on one side only, there is a small possibility of developing a hernia on the other side. Your surgeon may suggest surgery on the unaffected side to stop future hernia development.
Hernia repair is usually a day procedure, but in some circumstances, your child may need to stay overnight in the hospital for observation. This might happen because:
Complications are rare in inguinal hernia surgery, but may include:
After your child's surgery, you will be given some post-operative care instructions. Contact your child's surgeon or the hospital if:
Your doctor will arrange a follow-up appointment in the weeks following your child’s surgery. A doctor will need to check on your child’s wound and, if necessary, examine their testicles. This check-up may be performed as an outpatient at the hospital; or if you live far away, by a local
GP with consultation from a surgeon.
There is no set time for when your child may return to normal activities. Your child will begin to do things when they feel comfortable. However, it is recommended that your child does not play sports for two weeks. Speak with your child's surgeon if you need more information
about when normal activities may be resumed.
How soon after inguinal hernia diagnosis the surgery
It varies depending on the age of your child and the
severity of the hernia. The younger your child is, the earlier the inguinal
hernia should be repaired. In general, an uncomplicated inguinal hernia should
be fixed as soon as is practical. If the hernia is strangulated, the need for
an operation is more urgent.
How long will the surgery take?
It will vary, depending on the age of your child, the nature
of the anaesthetic to be used, and whether one or both sides of the groin will
be operated on. Your child will usually be away from you for one to two hours.
Was the inguinal hernia caused by anything I did?
There is nothing you
did or did not do that caused the hernia to develop. The opening in the
abdominal wall is present from birth and a hernia may develop at any time. They
are usually picked up in newborns, or within the first year of life. However,
they may go unnoticed for many years. There is no routine treatment of newborns
that will prevent the development of a hernia. Inguinal hernias are more common
in babies who are premature or have low birth weight, if there is a family
history of inguinal hernias, or if there are other problems such as undescended
Developed by The Royal Children's Hospital Paediatric Urology and Surgery departments. We acknowledge the input of RCH consumers and carers.
Reviewed March 2018.
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