Inguinal hernia in children

Pediatric inguinal hernia is a condition in which abdominal contents protrude through the groin area. It is a congenital disease caused by the persistence of the processus vaginalis, a canal that extends from the abdomen to the genital region. Inguinal hernia can occur in newborns, toddlers, young children, and even adults.

The disease may occur in:

  • Newborns, infants, toddlers, and even adults
  • Most commonly in children under 6 years old
  • Premature infants, who have a higher risk than full-term infants
  • Boys more often than girls
  • More frequently on the right side, but it may occur on both sides

Why is inguinal hernia dangerous in children?

Strangulated inguinal hernia is the most serious complication. A segment of the intestine or another organ becomes trapped in the hernia sac and loses its blood supply, leading to tissue necrosis. This is a surgical emergency. If not treated promptly, it can be life-threatening.

Symptoms of inguinal hernia in children

A bulge in the groin or scrotum: Easily seen when the child cries, strains, or runs and plays; it may become smaller or disappear when the child rests, lies down, or sleeps.

Warning signs of strangulated/incarcerated hernia – seek medical care immediately:

  • Severe pain, persistent crying or screaming
  • A hard bulge that cannot be pushed back in and increases rapidly in size
  • Red or purplish skin over the groin/scrotum
  • Fever
  • Vomiting, abdominal distension
  • Bloody stools

Complications

  • Intestinal necrosis due to strangulation
  • Testicular atrophy caused by compression of testicular blood vessels
  • Damage to herniated organs (ovaries, intestines, bladder, etc.)
  • Postoperative complications: bleeding, infection, injury to the vas deferens, recurrence of hernia

Treatment of inguinal hernia in children

  • Surgery is the only definitive treatment; the condition does not resolve on its own.
  • The common procedure is ligation and division of the processus vaginalis to prevent organs from protruding into the groin or scrotum.
  • Surgery can be performed using either open surgery or laparoscopic techniques, depending on the case.
  • Children usually recover quickly, can resume eating a few hours after surgery, and may be discharged within 24–48 hours.