Swelling in the groin or the inguinal region is usually noticed by the mother while giving a bath to her child. When the child is crying, the mother will notice a swelling that pops up in the groin. At times, there may be a visible swelling that increases when the child cries, strains or coughs. The mother will also find that the swelling is no longer seen when the child is asleep. This is an inguinal hernia. The reason for this hernia is simple; there is already a passage for the testis to come out from the abdomen to go into the scrotum. Usually, this passage closes after the testis has come down. If, the passage remains open it now allows the intestines from within the abdomen to come out and this is a Hernia. This child must be shown to a Pediatric Surgeon who is one trained specifically to deal with surgical problems in children only.
Once the diagnosis is confirmed by the Pediatric Surgeon, the child should undergo surgery as soon as possible. What it means that the condition is not urgent but operation should be done within 15 – 25 days after the diagnosis is confirmed. The reason for the hurry is that there is a high incidence of complications associated with an inguinal hernia that can occur up to 50% of cases in children under 1 year of age. The complications can be non reducibility of the intestines which have come out in the inguinal canal accompanied by pain, crying which can further increase the intestines coming out. Obstruction of the intestines that have come out causes abdominal distension, vomiting; later there can be cutting off of the blood supply of these intestines leading to gangrene. Hence, surgery should be done as soon as possible.
The operation is done under general anesthesia, so that the child as well as the surgeon is comfortable - the passage, in the form of a sac is opened, the intestines are pushed into the abdomen & the passage is tied off, so that there can be no recurrence. Most of children above 1 year of age are sent home the same day as operation so they do not need to stay in hospital overnight. Below 1 year of age, infants stay overnight in the hospital and go home the next day morning. Healing occurs within 5 – 7 days and the child is able to resume normal activities including school by 8 – 10 days after the operation. A close watch should be kept on the opposite side, which may also have an open passage but will be visible later. Hernias can and do occur also in girls but are less common than in boys. The therapy remains the same in either case.
Last updated on 01-03-2005