Inguinal Hernia

Inguinal Hernia in Children: Symptoms, Diagnosis, Treatment, and FAQs

What is an Inguinal Hernia?

An inguinal hernia is an opening in the lymph nodes or abdominal wall, commonly found in children. It occurs when a protrusion of the thoracic cavity forms a sac-like structure extending through the inguinal ring into the groin. The inguinal ring typically closes at birth, but in hernias, it remains open, allowing abdominal contents to bulge into the groin. In boys, a loop of the intestine may be involved, while in girls, it can include the bowel or other organs.

Symptoms of Inguinal Hernia

A bulge/swelling in the groin region
In boys, swollen scrotum due to internal organ entry
Swelling worsens with crying, coughing, or sneezing
Discomfort or pain in the groin

Diagnosis

Inguinal hernias:

Are more common in boys
May go unnoticed for years if small
Are often congenital (present at birth)
Are typically detected during physical exams
Become visible when the child strains

Treatment

Surgery is the only effective treatment. The timing depends on the child's strength and the doctor's recommendation.

Advantages of Surgery

Relief from swelling and discomfort
Prevents complications such as incarceration or strangulation
Laparoscopic surgery significantly reduces the risk of recurrence
Quick recovery: normal activity may resume within 48 hours

Types of Surgery

1. Open Hernia Repair

Small groin incision
Hernia is pushed back, sac removed
Abdominal wall reinforced with stitches and sometimes mesh
Usually performed under local, spinal, or general anesthesia

2. Laparoscopic Hernia Repair

Tiny abdominal incisions
A laparoscope with camera is used
Synthetic mesh placed over the defect
Performed under general anesthesia

Techniques:

Trans-peritoneal: Uses umbilical access; allows examination of both sides
Pre-peritoneal: Involves a tiny incision in the groin; hernia closed with external ligature

Procedure Overview

Before Procedure

Done under general anesthesia
Caudal anesthesia for pain relief
Child should fast for at least 6 hours
Operation duration: 30 minutes to 1 hour

During Procedure

Incision in the groin
Hernia sac identified, gut repositioned, sac removed
Muscles strengthened with stitches
Closure with dissolvable stitches and tape

After Procedure

Discharge within a few hours (or overnight for premature babies/medical issues)
Full recovery in 1–2 days
Sponge bath after 24 hours, full bath after 2 days
Surgical tape falls off on its own
No need to pull off tape manually

Frequently Asked Questions (FAQs)

Q: How Do I Know If I Have Appendicitis?

A: Pain starts at the belly button, then shifts to the lower right abdomen. Other symptoms: loss of appetite, nausea, vomiting.

Q: Where Is Appendicitis Pain Felt?

A: Commonly near the belly button initially, then moves to lower right abdomen. May also be felt near the groin or back.

Q: What Is the Nature of Appendicitis Pain?

A: Initially intermittent, later becomes constant and severe. Often accompanied by vomiting and nausea.

Q: Can Appendicitis Cause Back Pain?

A: Yes, especially pelvic or lower back pain due to the appendix’s location.

Q: Can Stress Cause Appendicitis?

A: No direct link, but anxiety and depression may contribute to gastrointestinal symptoms.

Q: How Long to Recover from Appendectomy?

A: Varies. Laparoscopic: short recovery. Open surgery: a few days in hospital, full recovery in a few weeks.

Q: What Precautions to Take Post-Appendectomy?

A: Follow doctor’s instructions. Disclose all medications/allergies. Arrange transport. Avoid self-medication.

Q: What Are Possible Complications After Surgery?

A: Bowel injury, abscess, intra-abdominal infection, stomach damage.