Inguinal Hernia / Hydrocele

What is an Inguinal Hernia?

An inguinal hernia is a bulge in the groin created by tissue or organs that are located within the belly (also known as the abdomen). In boys, this bulge is often found in the scrotum. The hernia typically contains either fat from within the abdomen or even intestines. When the child cries or coughs the bulge becomes larger and more conspicuous.

If bowel gets trapped outside of the belly, then its blood supply can be cut off which is dangerous and requires immediate surgery.

In girls, the ovary is the most common organ that is found within the hernia.

What is a hydrocele?

A hydrocele is fluid filled sac in the groin or scrotum. Hydroceles have similar physical exam findings as an inguinal hernia but no bowel or tissue is found within the sac. The hydrocele may connect to the abdominal cavity (thus called a communicating hydrocele) or have no connection (non-communicating hydrocele).

How common is an Inguinal hernia or hydrocele?

Inguinal hernia and hydrocele are a common condition in children and up to 5% of all children may develop either of them. Premature babies have a higher incidence of inguinal hernia.

What are the symptoms of Inguinal Hernia?

The most common initial symptom of an inguinal hernia is a bulge in the groin or scrotum. The bulge will typically come and go; it is often noticed while the child is straining or crying. When the child relaxes or sleeps, the bulge may go away.

If the hernia becomes trapped (incarcerated), it may mean that organs from inside the belly are trapped inside the hernia. The hernia is a small space and blood flow to the trapped organs may be decreased. The child will likely experience severe pain or tenderness. The bulge may also become much more firm or even red when this happens.Symptoms of a strangulated hernia (where the blood supply of the contents of the hernia is cut off) include severe pain, vomiting, refusal to feeds, redness or bruising around the bulge, and sometimes, fevers and bloody stools. These are alarming symptoms and one must rush to a pediatric surgeon immediately as the condition of the child can become critical and the child will require emergency surgery.

What are the symptoms of hydrocele?

Hydrocele usually presents with a bulge in the groin or scrotum. Fluid is made in the inside of the abdomen so if there is a communication between the hydrocele and the inside of the belly, the fluid can move back and forth from the scrotum into the belly, leading to change in size of the scrotum. Acute swelling of the hydrocele may lead to pain and tenderness to that area.

Are there any tests to confirm the diagnosis?

The diagnosis of inguinal hernia or hydrocele is made by clinical examination only. Sometimes, the doctor may advise ultrasonography to differentiate from other groin conditions like retractile testis, torsion of testis or inguinal lymphadenitis.

What is the treatment of Inguinal Hernia?

Surgery is the treatment of Inguinal Hernia. It is generally recommended that hernia should be fixed immediately, especially in infants, due to the risk of the hernia becoming trapped outside the abdomen and becoming a medical emergency.

A small skin crease incision is made near the bulge and the contents of the hernia are pushed back into the abdomen. The hole from which the organs are exiting from the abdomen (hernia) is closed. Mesh is not used in children unlike adult inguinal hernia surgery.

What is the treatment of Hydrocele?

Hydrocele may disappear on its own. If it doesn’t disappear by 2 years of age surgery should be performed. Communicating hydrocele may require surgery at an early age.

How long will the child stay in the hospital?

Typically, hernia surgery in children is a day care surgery. The child will be discharged on the same day after the surgery.