What is inguinal hernia?
A hernia is what happens when any tissue comes out of an opening in a muscle. In newborns, the most common hernia – and the most common surgical issue during childhood – is the inguinal hernia. This type of hernia occurs when a bowel or ovary comes through the inguinal ring, a triangular opening in the groin area.
This sac is open during your baby’s development in the womb, but it should close around the time of birth. For unknown reasons, sometimes this sac stays open and creates a pathway for organs to come through the abdomen and into the groin area. In boys, it’s usually part of the bowel that comes through. In girls, it’s either a bowel or an ovary.
Who gets it?
Doctors don’t know what causes this kind of hernia, but it generally occurs in five of 100 babies carried to full-term, and in 30 of 100 babies born early. Boys are 10 times more likely to get this kind of hernia than girls. It occurs most frequently on the right side (75 percent of cases) and less often on the left side (25 percent) or on both sides (15 percent).
What are the symptoms?
Because this hernia is in the groin area and involves part of the bowel pushing through an internal opening, you should be able to see a bulge in your baby’s lower abdomen, particularly when your baby is straining or crying. You may notice your baby show signs of discomfort if you’re touching this area during a diaper change.
If your child or baby begins vomiting, has diarrhea or difficulty passing stool, shows signs of sharp abdominal pain, or the skin over the bulging area begins to change color, the intestine or organ could be stuck in the hernia sac. When this happens, the organ can get pinched and lose its blood supply. This is a surgical emergency and should be treated immediately
Will my child need surgery?
These types of hernias never go away without treatment, so surgery is likely. Surgeons will “push” the organs back through the sac and close it up. Leaving the sac open increases the risk for an organ to be pinched, causing a surgical emergency. When an organ is pinched, its blood supply is cut off. This can cause serious damage to the affected organ.
Surgery for an inguinal hernia takes about an hour. The pediatric surgeon will close the opening to the sac either laparoscopically or with an open approach. Laparoscopic surgery uses two or three small incisions that instruments and a camera are passed through. In some children, the surgery will need to be done through a longer incision in the groin. Your child’s surgeon will talk with you about which option is best for your child.
Will my child have to stay in the hospital?
If your child was born prematurely and is less than a year old when the hernia is repaired, he or she will need to spend the night after the surgery. This allows the pediatric surgery and anesthesia team to monitor your child after anesthesia. Older children can often go home the same day as the surgery as long as they are able to drink and have adequate pain control in the recovery area.
Your child’s evaluation
If you or your child’s doctor believes your child may have an inguinal hernia, we will schedule an appointment at University of Iowa Stead Family Children’s Hospital in Iowa City or one of our clinics in the Quad Cities or Waterloo. During this appointment, you and your child will meet with one of our surgeons and pediatric surgery team members. Here you will be counseled on treatment options, the possibility of surgery, perioperative care, and follow up treatment.