Inguinal Hernia in Children

What is an inguinal hernia in children?

A hernia occurs when a part of the intestine or other abdominal tissue pushes through a weakness in the belly (abdominal) muscles. A soft bulge shows up under the skin where the hernia is. A hernia in the groin area is called an inguinal hernia.

What causes an inguinal hernia in a child?

A hernia can develop in the first few months after a baby is born. It happens because of a weakness in the abdomen muscles. Straining and crying don’t cause hernias. But the increased pressure in the belly can make a hernia more easily seen.

As a male baby grows during pregnancy, the testicles develop in the abdomen. Then they move down into the scrotum through the inguinal canal. Shortly after the baby is born, the inguinal canal closes. This stops the testicles from moving back into the abdomen. If this area does not fully close, a part of the intestine can move into the canal through the weakened area of the lower belly wall. This causes a hernia.

In some cases, the part of intestine that pushes through a hernia may become stuck. It is no longer reducible. This means it can’t be gently pushed back into the belly. When this happens, that part of the intestine may not get enough blood. A good blood supply is needed for the intestine to be healthy and to work the right way.

Girls don’t have testicles. But they do have an inguinal canal. So they can also have hernias in the groin.

Which children are at risk for an inguinal hernia?

Hernias happen more often in babies who are born early. They are also more common in children who have:

• A parent or sibling who had a hernia as an infant

• Cystic fibrosis

• Developmental dysplasia of the hip

• Undescended testes

• Problems with the urethra

What are the symptoms of an inguinal hernia in a child?

Inguinal hernias look like a bulge or swelling in the groin or scrotum. You may be able to see the swelling more easily when the baby cries. It may get smaller or go away when the baby relaxes. If your child’s healthcare provider gently pushes on this bulge when your child is calm and lying down, it will often get smaller or go back into the belly.

If the hernia can’t be pushed back into the belly, the loop of intestine may be stuck in the weakened part of abdominal muscle. If that happens, symptoms may include:

• A full, round belly

• Vomiting

• Pain or fussiness

• Redness or a color that's not normal

• Fever

• Firm and tender bulge

These symptoms may look like other health problems. Make sure your child sees their healthcare provider for a diagnosis.

How is an inguinal hernia diagnosed in a child?

To diagnose a hernia, your child’s healthcare provider will do a physical exam. They will check if the hernia can be pushed back into the abdomen (reducible).

How is an inguinal hernia treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Your child will need surgery for an inguinal hernia. The surgery will happen fairly soon after the hernia is found. That’s because the intestine can become stuck in the inguinal canal. When this happens, the blood supply to the intestine can be cut off. The intestine can then become damaged. Surgery is often done before this damage can occur.

During surgery for a hernia, your child will be given medicine to put them to sleep (anesthesia). The surgeon makes a small cut (incision) in the area of the hernia. The surgeon puts the loop of intestine back into the abdominal area. They stitch the muscles together. Sometimes a piece of meshed material is used to help strengthen the area where the muscles are fixed.

What are possible complications of an inguinal hernia in a child?

Complications of an inguinal hernia include:

• Part of the intestine becoming stuck in the belly muscles

• Lifelong (permanent) damage to the intestine because of not enough blood flow

Key points about an inguinal hernia in children

• A hernia occurs when a part of the intestine or other abdominal tissue pushes through a weakness in the belly muscles. When that happens in the groin area, it’s called an inguinal hernia.

• Inguinal hernias often occur in newborns.

• Babies born early or who have a family history of hernias are more likely to develop one.

• Inguinal hernias show up as a bulge or swelling in the groin or scrotum. Sometimes they can be pushed back into the belly.

• Your child needs surgery to treat an inguinal hernia.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.