A hernia occurs when a section of intestine protrudes through a weakness in the abdominal muscles. A soft bulge is seen underneath the skin where the hernia has occurred. An inguinal hernia is a type of hernia that occurs in the groin area.
What causes an inguinal hernia?
A hernia can develop in the first few months after the baby is born because of a persistence of the communicating channel between the abdomen and scrotum (processus vaginalis). As a male fetus grows and develops during pregnancy, the testicles develop in the abdomen and then move through a channel called the processus vaginalis into the scrotum. The processus vaginalis is located in an area called the inguinal canal. Shortly after the baby is born, the channel through the inguinal canal closes, preventing the testicles from moving back into the abdomen. If this area does not close off completely, a loop of intestine can move into the inguinal canal and scrotum through this open channel.
Although girls do not have testicles, they do have an inguinal canal, so they can develop hernias in this area as well.
Who is at risk for developing a hernia?
Hernias occur more often in children who have one 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
Who is affected by inguinal hernias?
Inguinal hernias occur:
- More often in premature infants
- In children who have a family history of inguinal hernias
- More often in infants and children with other urogenital anomalies.
- More often in the right groin area than the left, but can occur on both sides
Occasionally, the loop of intestine that protrudes through a hernia may become stuck, and is no longer reducible. This means that the intestinal loop cannot be gently pushed back into the abdominal cavity. When this happens, that section of intestine may compress its blood supply. A good blood supply is necessary for the intestine to be healthy and function properly.
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. Each child may experience symptoms differently. Symptoms may include:
- A full, round abdomen
- Pain or fussiness
- Redness or discoloration
The symptoms of an inguinal hernia may resemble other conditions or medical problems. Always consult your child's doctor for an accurate 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.
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
A surgical operation is necessary to treat an inguinal hernia. The hernia will be surgically repaired fairly soon after it is discovered 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.
During a hernia operation, your child will be placed under general anesthesia. A small incision is made in the area of the hernia. The loop of intestine is placed back into the abdominal cavity. The open channel is closed and the muscles are then stitched together.
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.
Georgia Pediatric Urology's expertise includes the evaluation and surgical management of inguinal hernias. Call today to schedule an appointment with a physician in one of our convenient office locations.