Best treatment of Hernia in children

Hernias are very common in young children. Congenital inguinal hernia is the most common of these. So let’s understand the information about hernia in children.

What is a hernia in children ?

When there is weakness in the abdominal muscles, the intestines come out of this part of the weakness. This is called hernia. This hernia looks like swelling under the skin. But in children, hernia is due to the non closure of the inguinal canal which lead to inguinal hernia in children.

What are the types of hernia in children ?

There are many types of hernias and their treatments vary. Inguinal hernia and Umblical hernia are very common in young children.

  • Inguinal Hernia in children

An inguinal hernia is a hernia that occurs in the groin. This hernia is eight times more common in boys than in girls.

In boys, the testis is in the abdomen and before birth it enters the scrotum (the sac below the penis) through the inguinal canal and this passage is usually closed but in some babies this passage is not closed.

So when the pressure in the abdomen increases, the intestines from the abdomen enter the scrotum. Therefore, the part that looks swollen is called inguinal hernia.

Hernias in children is not due to muscle weakness but due to the non-closure of the inguinal canal. while in adults inguinal hernia caused due to the muscle weakness.

  • Umblical Hernia in children

This type of hernia called benign hernia, is more common in newborns when the baby’s intestines protrude from the abdominal muscles of umblicus. Often Umblical hernia is cured without any treatment. If the hernia does not subside even after the age of three, then surgery may be required.

Sometimes, there may be swelling along with umblical hernia which is known as umblical granuloma.

  • Epigastric Hernia in children

When the intestines of the abdomen protrude from the muscles above and below the chest. This is called an epigastric hernia.This hernia is small. It does not require surgery. But if the hernia is large and the baby has symptoms, surgery may be needed.

What are the symptoms of a hernia in children ?

If your child has a hernia, it looks like a swelling in the groin. This swelling is most often seen when the baby is crying and pushing hard. Swelling in the groin is painless but decreases when the baby stops crying.

An inguinal hernia is more often seen on the right side but can also be on the left side or on both sides at the same time.

When the intestines from the abdomen are able to move freely in and out of the abdominal muscles gap , it is called Reducible Hernia.

Hernia Risk Factors

Inguinal hernia is more likely to occur when someone in the household has had a hernia as a child. Inguinal hernia can occur if the baby is born preterm.

Causes of Hernia

Hernias are most often caused by muscle weakness, but other major causes of hernias are abnormal growth of abdominal muscles of fetus during pregnancy. Therefore, hernias in children are congenital.

How is a hernia in children diagnosed?

Hernias are diagnosed by physical examination. However, sonography is also often performed. So that it is clear whether the hernia is on one side or on both sides and whether there is another disease along with the hernia or not.

What complications can occur in a hernia in children ?

In hernias, when the intestines come out of the weak muscles and if this part of the intestine gets stuck in that muscle gap, the blood supply to that part can be cut off and such a hernia cannot be reduced.

How to recognize a strangulated hernia?

When the following symptoms appear near the swollen area, the hernia should be considered stangulated.

  1) The swollen area may be red or dark blue.

  2) The baby may be experiencing nausea or vomiting.

  3) There may be pain in the abdomen.

  4) There may be fever.

  5) If you put your hand on the swollen area, it will be painful.

  6) The swollen area may not change shape.

         It is important to contact your doctor if you notice any of the above symptoms. This requires immediate operation.

What is the treatment for hernia in children ?

Treatment of hernia is surgery only. Hernia surgery is performed in the traditional way or with laparoscopy.

Hernia surgery is done under spinal anesthesia or general anesthesia as per the situation of the patient. So you will not feel pain during the hernia surgery. Before operation you must have fast for 5-6 hour as it decreases risk of anesthesia.

The traditional method of surgery is by giving incision in the groin and after finding the sac the path of the sac is closed with the help of suture so that hernia got repaired and there will no recurrence of hernia in future.

In laparoscopy (hernia repair in children), hernia sac is closed with the help of laparoscope from inside the abdomen. In laparoscope, there are two small incision taken near umbilicus for insertion of laparoscope and open hernia sac is closed with the help of sutures.

If hernia is bilateral then laparoscopic repair of hernia is one of the best treatment. If it is unilateral then the traditional method is perfect.

Mesh is not needed in young children. General or spinal anesthesia is used to operate on a hernia. This information is provided by the anesthesiologist at the time of the operation.

Hernia surgery is a day-care operation. Patient is discharged on the same day. If the hernia is strangulated, then the hospital stay may increase.

What are the complications of hernia surgery?

Complications of hernia surgery are very rare. Injury to the testis, Injury to the semen tube. A hernia operation is an operation on a very delicate area. Pain after surgery is not much more common but if you are suffering from post operative pain, your doctor may prescribe medicine for the pain. It is important to have surgery by a specialist pediatric surgeon to avoid the above complications.

Frequently Asked Questions

How old children can get a hernia?

A hernia that can occur in a baby at birth is called an infantile hernia. So hernia can present in baby since birth.

When should a hernia be diagnosed and operated on?

Hernia surgery is not an emergency surgery. But most of the time, it is an emergency after the hernia gets strangulated.

Can surgery cure hernia?

Yes. Closing the way for hernia is possible only with surgery. There is no other option for this. Often patients try to get treated without surgery and eventually complications occur and surgery is required.

When baby can play after a hernia operation?

Children can start playing as soon as they are out of consciousness. They are given medicine to reduce the pain.

What is the risk of a hernia operation?

The risk of hernia surgery is very low. The risk of anesthesia in the operation may be small. When the doctor gives all the information about the operation before the operation, it is important to resolve any doubts you may have.

Should hernia surgery be performed in older age?

No. Hernia surgery should be done as soon as possible after diagnosis, because if the intestine gets stuck in a hernia, it is an emergency, so the operation has to be done immediately as the risk to the baby’s life also increases and the cost of the operation increases.

Does a hernia again appear after surgery?

The rate of recurrence of hernia surgery is very low.

Does a hernia occur only in boys ?

Inguinal hernia in boys is eight times more common in boys than in girls.

What is the cost of hernia surgery in India?

The cost of the hernia surgery vary from hospital to hospital and surgery procedure. But average from 30000 -80000 is the cost of hernia surgery.

How to self evaluate inguinal hernia ?

Any form of buldging in the inguinal area is alarming. So at such time you can predict it but always consult your doctor immediately for diagnosis of inguinal hernia.

Is it possible to retard the progression of inginal hernia ?

Most commonly inguinal hernia is congenital defect so we can not retard the progress of inguinal hernia. So it is always better to consult your doctor when you have inguinal hernia.

Ref – Inguinal Hernia – Cincinnatichildren

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