Inguinal hernia

What is an inguinal hernia?

A hernia is an opening in the wall of a muscle, tissue, or sac that holds an organ, like the bowel, in place. If a hernia is big, a part of the organ may be able to push through the hole. An inguinal hernia is near the groin and the bowel pushes through the hole. 

 Most often, the sac that holds the bowels and fluids closes before a baby is born. If it doesn’t close, it becomes a hernia. These hernias are common in babies and children. They happen more often in boys and premature infants. Surgery is needed to fix an inguinal hernia so that important organs do not get stuck in the hernia.

How does it affect my child?

Hernias can be seen as a bulge under the skin. In girls, it will be in the groin or labia. In boys it will be in the groin or scrotum. The bulge may happen when your child cries, strains or stands. Most often it goes away when your child relaxes. Sometimes the hernia will stay out all of the time. Your doctor may show you how to push it back in, so it does not stick out. This is called reducing the hernia. Do not try this unless your doctor shows you how to do it.

Sometimes an inguinal hernia will get stuck. Call your doctor right away if your child has:

• Sudden, severe pain in the lower stomach or groin.
• A hard, tender lump in the groin that does not move or change.
• Skin in the groin or scrotum that looks red.
• Upset belly or throwing up with pain or swelling in the groin.

When Should My Child Have Surgery?

It is stressful to hear your newborn or child will need surgery.  For newborns and infants, often surgery is done fairly soon after the hernia is found. .  This is because newborns and infants have a high rate of having important organs getting stuck in the hernia. This can make them very sick. When surgery is needed, it is important that this be performed at a hospital like Children’s Wisconsin. Here there are pediatric surgeons, pediatric anesthesiologists and pediatric nurses. They make doing surgery and anesthesia in young children safer.

What is done during surgery to fix the hernia?

In children, the repair is often done with just stitches made on the inside of the body. This can be done through small incisions or cuts.  Children less than 4 years of age more often have two hernias. One on each side of the body.  Sometimes the second hernia is not easy to find.  Your surgeon may talk to you about using special tool as part of the first hernia fix to see if there is another hidden hernia. This tool is called a laparoscope. If they find a second hernia they will fix it at the same time.  Hernias almost never come back after they are fixed. It happens much more in adults. 

What do I need to know before my child’s surgery?

A nurse will call you 1 to 3 days before your child’s surgery.  The nurse will go over what to do before surgery. The nurse will also tell you when your child must stop eating and drinking. It is very important to follow these instructions. Surgery will be canceled if they are not followed. This is for your child’s health and safety.

What can I expect after surgery?

Most children and older babies can go home the same day after surgery. Before going home, your child will need to:

• Take enough fluids.
• Feel comfortable or be easily comforted.

Most often these children will need to stay in the hospital for 12 hours or longer after surgery:

• Premature babies.
• Infants under 3 months old.
• Children with other health care health issues may need to stay longer too.

If an overnight stay is needed your child will spend the night in their own room in the hospital.  The nurses will use a monitor to check your child’s breathing. They will help your child with pain medicines and starting to eat and drink. The medical team will make sure your child is comfortable and ready for home. The surgeon and anesthesiologist will talk about this with you. 

As you get ready to leave the hospital after surgery your child will get an After Visit Summary (AVS). The AVS will have the information to help you care for your child at home. It will also tell you about medicines to take or reasons to call the doctor. 

Most children will be feeling good after a few days at home. You will see your surgeon for follow up about a month after surgery. We can often do this follow-up using a virtual video visit.  We use the Children’s Wisconsin MyChart App for this option.

Resources
– https://childrenswi.org/patients-and-families/milwaukee-campus/guide-to-surgery/preparing-for-surgery
– www.childrenswi.org/learn