A boy with groin swelling (Inguinal Hernia)

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A boy with groin swelling (Inguinal Hernia)

3 months male child presented with swelling in the left groin region since birth. The swelling increases on crying and straining. On examination, there was a bulge in the left inguinal (groin) region and silk glove sign was positive on palpation which confirms the presence of hernia.

Ultrasound was done which showed herniation of bowel loops in the left hernial sac. He was planned for inguinal herniotomy.

Incision was given in the lowest inguinal crease. Deepened in layers. External oblique aponeurosis incised. Hernia sac identified and carefully dissected off the cord structures safeguarding the vas and spermatic vessels. Sac was divided and ligated proximally at the level of preperitoneal pad of fat. Distal sac was laid open. Incision was closed in layers from external oblique to skin.

Inguinal hernia in children:

Inguinal hernia is a common condition which occurs in children. This occurs when a portion of the intestine or other abdominal tissue pushes through a weak spot in the abdominal wall. During development of the child in the womb, the baby’s testicles are formed in the abdomen, and they gradually descend through the inguinal canal into the scrotum by 9 months of age. This canal is supposed to close spontaneously after birth. If the canal does not close completely, it remains open which allows abdominal contents to enter it, hence causing inguinal hernia. In female babies, though there are no testicles, the inguinal canal forms and must close spontaneously after birth. If it remains open, then inguinal hernia can occur in female child.

The most common sign in inguinal hernia is a soft bulge in the inguinal region. It becomes more noticeable when the child is crying, coughing, straining during a bowel movement or standing up. It may disappear when the child is relaxed or asleep.

Inguinal hernia in children do not resolve on its own and will need surgery to repair it. Your pediatric surgeon will recommend inguinal herniotomy if you child is diagnosed with inguinal hernia. In this procedure, the inguinal hernia sac is dissected carefully, divided and closed using a suture.

If an infant is diagnosed with inguinal hernia as in the above case, early repair is recommended due to high risk of bowel obstruction and strangulation.

Dr A.K Singal and Dr Ashwitha Shenoy, pediatric urologists at MITR hospital have experience in operating thousands of children with inguinal hernia. Any child who presents with groin swelling is carefully examined and surgery is recommended only if necessary. The surgery is usually a day care procedure and children are discharged by evening on the same day of surgery.

Inguinal Hernia repair surgery (Herniotomy) in a child- Dr A.K. Singal, Mumbai, India