Inguinal hernia surgery is one of the most common surgeries performed in infants and children.
An inguinal hernia happens when part of the membrane lining the abdominal cavity or intestine protrudes through a weak spot in the abdomen, often along the inguinal canal. This can form a bulge in the groin or scrotum, which can be painful.
There are two types of inguinal hernias, direct inguinal hernia and indirect inguinal hernia.
A direct inguinal hernia penetrates directly through the wall of the inguinal canal.
An indirect inguinal hernia enters the inguinal canal through the top. This usually occurs because of a birth defect, when the opening of a fetus’s canal doesn’t close all the way during development in the uterus. The inguinal canal extends from a child’s abdomen to their genitals.
Inguinal hernias usually only develop on one side of a child’s groin, developing on the right side more often than on the left side. About 10% of the time, inguinal hernias develop on both sides of the groin.
Inguinal hernias are most common in children six years of age or younger, and are more common in premature infants, with 90% of them affecting baby boys.
A baby boy’s testicle forms above the lower abdominal wall and descends through the inguinal canal into the scrotum. The place where the testicle passes through is more susceptible to a hernia because it is a preexisting opening.
In females, the inguinal canal is narrower and begins under the abdominal wall. It carries the round ligament that supports the uterus, and this tough ligament helps to reinforce the muscle wall. However, if a female has connective tissue disease, they may be more susceptible to hernias where connective tissue attaches the uterus to the inguinal canal. Congenital indirect inguinal hernias may also affect baby girls, but it is rare.
Not all inguinal hernias have symptoms. Sometimes, symptoms come and go. A hernia may slide in and out of the opening, or a child may only feel it during certain activities.
In children, you may see a lump in their groin area that gets bigger when they cry. It may go away when they sleep. An inguinal hernia may not always be noticeable because it may be tucked behind muscle fibers.
Some signs and symptoms of an inguinal hernia include:
- A bulge in the area of the pubic bone, which becomes more obvious when upright, especially if you cough or strain
- A burning or aching sensation at the bulge
- Pain or discomfort in your groin, especially when bending over, coughing, or lifting
- A heavy or dragging sensation in the groin
- Weakness or pressure in the groin
- Occasional, pain and swelling around the testicles when the protruding intestine descends into the scrotum
- Crankiness and difficulty feeding in infants
Some inguinal hernias have no apparent cause. Other causes of hernias can include:
- Increased pressure within the abdomen
- A preexisting weak spot in the abdominal wall
- Straining during bowel movements or urination
- Strenuous activity
- Chronic coughing or sneezing
Some risk factors that contribute to developing an inguinal hernia include:
- Being male
- Family history
- Premature birth and low birth weight
- Previous inguinal hernia or hernia repair
A physical exam is usually performed to diagnose an inguinal hernia in a child. A doctor will check for a bulge in the child’s groin or scrotum area while they are straining or crying, and then determine if it goes away when they are relaxed. If the child is old enough, they may ask them to stand and cough or strain because standing and coughing can make a hernia more prominent.
An inguinal hernia in a child is usually treated as soon as possible, as children are more at risk of dangerous complications from them. Complications that can develop from an inguinal hernia include:
- Incarcerated hernia- occurs when the contents of the hernia get stuck. When this happens, a child’s healthcare provider can’t push the hernia back into their abdomen
- Strangulated hernia- occurs when the hernia gets stuck and cuts of the blood supply to the child’s intestines. The lack of blood flow to a child’s intestines can cause tissue death. This is a serious and painful condition and is a medical emergency
Healthcare providers recommend surgery for most inguinal hernias. The types of surgeries used to repair inguinal hernias include:
- Open surgery
- Laparoscopic surgery
Our friendly on-site staff members are happy to provide you with the information you need about the surgical options available to your child at Jamaica Hospital Medical Center. For more information about our Queens, NYC surgical services or to make an appointment, please call (718) 206-7001.
All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.