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Pediatric Surgery Health Topics

Inguinal Hernia

What is inguinal hernia?

An inguinal hernia occurs when part of an internal organ bulges through a weak area of muscle that forms the wall of the abdomen at the groin.  This may result in a visible groin bulge or (in males) a bulge or mass within the scrotum.  The bulge may hurt or burn at times.  Although a groin hernia is the most common form of hernia are other types of hernias, there are other types of hernia, including

  • Umbilical, a bulge around the belly button
  • Incisional, a bulge through a scar
  • Hiatal, a small opening in the diaphragm that allows the upper part of the stomach to move up into the chest.
  • Congenital diaphragmatic, a birth defect that needs surgery

Most inguinal hernias happen because an opening in the muscle wall does not close as it should before birth. That leaves a weak area in the belly muscle. Pressure on that area can cause tissue to push through and bulge out. A hernia can occur soon after birth or much later in life.

Symptoms:

The main symptom of an inguinal hernia is a bulge in the groin or scrotum. It often feels like a round lump. The bulge may form over a period of weeks or months. The hernia may be painful, but some hernias cause a bulge without pain.

A hernia also may cause swelling and a feeling of heaviness, tugging, or burning in the area of the hernia. These symptoms may get better when you lie down.

Sudden pain, nausea, and vomiting are signs that a part of your intestine may have become trapped in the hernia. Untreated hernias can cause pain and health problems.

Diagnosis:

A doctor can confirm the presence of a hernia during a physical exam. The mass may increase in size when coughing, bending, lifting, or straining. The hernia (bulge) may not be obvious in infants and children, except when the child is crying or coughing.

Treatment:

The usual treatment for a hernia is surgery to repair the opening in the muscle wall. There are various surgical strategies which may be considered in the planning of inguinal hernia repair. These include the consideration of mesh use, type of open repair, and use of laparoscopy, a more minimally invasive approach to abdominal surgery.

However, smaller hernias with no symptoms can sometimes be watched. Most people with hernias have surgery to repair them, even if they do not have symptoms. This is because many doctors believe surgery is less dangerous than strangulation, a serious problem that occurs when part of your intestine gets trapped inside the hernia.

Babies and young children are more likely to have tissue get trapped in a hernia. If your child has a hernia, he or she will need surgery to repair it.

The Division of  Pediatric General Surgery at Johns Hopkins Children's Center treats inguinal hernias.

External Links:

Inguinal hernia from the National Library of Medicine