Inguinal Hernia in Baby

This is a condition where there is an abnormal connection between the abdominal cavity and the groin. Therefore loops of intestine and other internal organs can escape through this communication. In children these usually need to be repaired fairly urgently as there is a high risk of strangulation where these internal organs can get stuck outside the abdominal cavity causing an emergency. Treatment is quite simple with a day case operation through a tiny incision or with laparoscopy

Symptoms

Typically hernias present as a lump or swelling in the groin. The swelling typically comes and goes. If the hernia gets stuck then it may present acutely as a painful hard lump in the groin, and may be associated with vomiting.

Causes

Inguinal hernias in children occur due to the persistence of a communication between the abdominal cavity and the groin which should have closed off after birth. This is called a patent processus vaginalis.

Treatment

Inguinal hernias in children must be repaired in order to prevent strangulation. The procedure to repair the hernia is called a herniotomy. Under a general anaesthetic, the communication between the abdominal cavity and the groin is tied off and divided. The procedure may be performed using a laparoscopic approach or through a tiny groin incision.

Pre-Surgery

As a general anaesthetic will be required, we will usually provide you with fasting instructions. You will have the opportunity to visit our day case ward if you require and we can also provide access to play therapists in order to help prepare your child for surgery.

Post-Op

Most cases are carried out as a day case so you will be able to take your child home a few hours after surgery. Smaller babies often have to spend one night in hospital.

FAQ’s

A hernia occurs when abdominal contents such as intestine protrude out of the abdominal cavity through a communication in the groin towards the scrotum. This is called an inguinal hernia. There are other forms of hernia such as umbilical hernia.
Sometimes the abdominal content gets stuck in the communication and can't get back into the abdominal cavity. This is called incarceration. This can cause the death of the content of the hernia such as intestine or in girls, the ovary.
A general anaesthetic will be needed to perform this operation.
Most children are able to go home the same day but small babies usually need to be kept in hospital overnight.
Through a tiny incision in the groin, we find and tie off the communication between the abdomen and the scrotum thereby eliminating the hernia. This procedure can also be performed using keyhole surgery.
Repair of a hernia is usually completely safe. The most important complication is damage to the vas deferens which is the tube that drains the sperm from the testicles or damage to the blood supply to the testis. This is very rare though and occurs less than 1% of the time.
Children bounce back very quickly and are usually fully recovered within a week.
Usually we recommend keeping the wound dry for 2 days and then bathing normally. The stitches usually dissolve on their own and do not need to be removed.
Children are usually safe to go back to school after one week.
The child will only need pain killers such as paracetamol or ibuprofen.

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Mr. Feilim Murphy

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