Inguinal Hernia

Inguinal hernia is one of the most common surgical problems among children. It results from a small sac that comes out through an opening in the groin. This opening normally closes at the time of birth. if for some reasonsit remains open, then it makes a pathway for abdominal organs (usually intestine) to come out through the opening.The hernia first appears as a bulge in the groin when the child cries or strains, and may appear or disappear, or may be present all the time. Usually it is diagnosed on clinical examination and the history given by the parents. No investigations are required. Hernia can present on one side or can be seen on both the sides at the same time. In small percentage of cases it can appear later on, on the opposite side.

Inguinal hernias never go away without a surgery. This is a condition in which surgery is advised to be done as early as possible. The reason being, if the sac is left open, there is high risk of a loop of intestineor some other organ getting entrapped (incarcerated) in the sac,which can swell and compress the blood supply. Without adequate blood supply, the organ trapped in the hernia sac can get damaged or even die. This condition then becomes an emergency and then the child needs an urgent surgery. If your child has an incarcerated hernia, he or she may have a hard, red, painful lump, may vomit, and may be unwilling to eat.

The surgery can be done by open or Laparoscopic technique. The surgery takes about 30-40 minutes. It is a day care procedure.The hernia sac is closed through a small incision in the groin. There will be no stitches to be removed from the skin later because the stitches will all be under the skin and will dissolve on their own. Your child's skin will be covered with a small water proof dressing.

Hernia in children unlike adults does not require mesh

Once the child is fully awake he/she can be started on liquid diet after 2-3 hrs of surgery followed by normal diet. Most of the children will just require mild pain killers after surgery.

The dressing will be removed 5 days after surgery in the opd. These stitches are under the skin and do not have to be removed. For children who are not toilet trained loose diapers should be used to avoid the dressing getting wet. In case the dressing comes out, you can contact us for a dressing change. There will be some swelling at the incision siteand may take few days to go away completely. Your child may take a bath 5 days after surgery, once the dressing has been removed. Before then, he or she may take a sponge bath. There are no specific physical activity restrictions.

Dr. Ashish Prasad

Consultant Paediatric Surgery and Paediatric Urology
MBBS, DNB (General Surgery), DNB (Paediatric Surgery)

View Full Profile