Genital Disorders: Inguinal Hernia

Question 1

Are inguinal hernias common?

Answer 1

Yes - they occur in up to 5% of boys and even more common in premature babies

Question 2

What is a hernia usually caused by?

Answer 2

A persistently patent processus vaginalis and emerges from the deep inguinal ring through the inguinal canal

Question 3

Is it usually direct or indirect?

Answer 3

Indirect

Although in premature babies, when tissues are weak, direct hernias more likely than in older children

Question 4

How does a hernia present?

Answer 4

A lump in the groin - may extend into scrotum or labium
Usually asymptomatic
May be intermittently visible due to straining

Question 5

What complications can occur?

Answer 5

Incarceration

• the contents of the hernia irreducible
• can cause pain, tenderness, erythema and intestinal obstruction

Strangulation - if the blood supply becomes obstructed
(Irreducible, painful lump - pain often out of proportion to clinical signs)

Question 6

Is the risk of incarceration higher in infants or older children?

Answer 6

Infants

Question 7

Most hernias can be successfully reduced by…

Answer 7

Gentle compression in the line of the inguinal canal with analgesia

Question 8

How is it managed?

Answer 8

Surgery - ligation and division of processus vaginalis (the hernia sac)

Question 9

If reduction is impossible, what is required?

Answer 9

Emergency surgery - risk of compromise to bowel or testis