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Inguinal Hernia

Newborn baby with inguinal hernia

What is an inguinal hernia?

An inguinal hernia can affect both male and female infants.

As a male fetus grows and develops during pregnancy, their testicles begin growing in their abdomen first. Then, they slowly move down into their scrotum, passing through a tunnel-shaped area called the inguinal canal.

Soon after they’re born, the opening to the inguinal canal, called the processus vaginalis, should close. This keeps the testicles in place and prevents them from moving back into the baby’s abdomen. However, in some cases, this area does not close off completely.

When that happens, a small loop of the baby’s intestine can travel downward, moving into the inguinal canal through a weakened portion of their abdominal wall.

This causes a hernia to develop. While females do not have testicles, they do have an inguinal canal, putting them at risk for developing a hernia.

Inguinal Hernia Symptoms

Though inguinal hernias most often occur in newborns, they may not be noticeable right away. It could take a few weeks or months for them to appear after birth.

While some people associate excessive straining or crying with hernias, it’s important to note that these actions alone cannot cause one to develop. However, they can exacerbate any symptoms that are already present. For instance, if the hernia is putting pressure on the baby’s abdomen, it can become more noticeable when they strain.

The most common symptom of an inguinal hernia is bulging or swelling in the baby’s groin or scrotum. While the inflammation might become more pronounced when they cry, it may appear to get smaller or disappear altogether when they’re calm and relaxed.

If your baby’s physician notices this bulge, they may push on it gently when your baby is lying down. When they do so, it should diminish in size or retreat into their abdomen. In medical terms, this means it is reducible.

If the hernia does not move inward, this could indicate that there’s a loop of the baby’s intestine caught in a weakened part of the abdominal muscle. When this is the case, you may notice the following inguinal hernia symptoms:

  • A full, distended abdomen
  • Pain or discomfort
  • Fussiness
  • Redness or discoloration
  • Fever
  • Vomiting

Inguinal Hernia Causes

An inguinal hernia is caused by a weak area that develops in the baby’s abdominal muscles. It usually becomes pronounced in the first few months after birth. While this type of hernia can occur on both sides of a baby’s groin, it’s typically located on the right side.

Who gets inguinal hernias?

Some infants are at a higher risk of developing a hernia than others. This includes those who have:

  • A parent or sibling who had a hernia as an infant
  • Developmental dysplasia of the hip
  • Cystic fibrosis
  • Undescended testes
  • Abnormalities of the urethra

Inguinal hernias are a specific type of hernia, and they also have their own risk factors. While both male and female infants can get inguinal hernias, they are most common in infants who:

  • Are male
  • Are born prematurely
  • Have a family history of inguinal hernias
  • Are experiencing other types of urogenital anomalies

How are inguinal hernias diagnosed?

The symptoms of an inguinal hernia can mimic several different conditions, so it’s important to get a professional diagnosis.

Your child’s physician can perform a physical exam to determine if there is a hernia present and if it is reducible. If they need to examine their intestine more closely, they may order an ultrasound or abdominal x-rays to get a closer look.

Inguinal Hernia Treatment

After performing the exam, your child’s physician may recommend inguinal hernia treatment. The type of treatment they recommend will be based on a few different factors, including:

  • Your child’s age, medical history, and overall health
  • Whether the hernia is reducible or not
  • The type of hernia present
  • Your child’s personal preference for certain medications, treatments, and procedures
  • The personal preference and opinion of their parent

When is surgery needed?

If the physician notices a non-reducible bulge in the child’s inguinal area, they will usually schedule an operation as soon as possible. Prompt treatment is necessary to prevent the intestine in the inguinal canal from becoming trapped or strangulated, which could cut off its blood supply. If the hernia is noticeably strangulated, emergency surgery is required.

What can I expect from surgery?

Before the hernia surgery, a physician will place your child under anesthesia. Then, they will make a small incision at the site of the hernia and gently place the loop of the intestine back into their abdominal cavity.

If they need to strengthen and fortify the area where the muscles were repaired, they may also add a piece of mesh material at the site. Often, the surgeon will check the other side of the baby’s abdomen for signs of an inguinal hernia because it is common for them to occur on both sides, even if one side is pronounced and the other is not.

This is usually a simple procedure. Most children who undergo inguinal hernia repair surgery can go home on the same day as the operation. They must be fever-free, able to eat and drink, and able to take pain medication by mouth before their release.