Many parents find that one side of the balls is swollen when they bathe their child, and the swelling appears or increases significantly when the child cries, coughs or stands up, and gradually shrinks to disappear completely when lying quietly or getting up in the morning.
In fact, the enlarged side is not really bigger, but there is fluid inside the scrotum wrapped around the balls or the intestines have fallen in, which is clinically known as syringomyelia and hernia. In fact, whether it is syringomyelia or hernia, the etiology is the same, both are due to unclosed peritoneal sheath, only the difference is that what falls down in hernia is intestine or omentum, and what falls down in syringomyelia is fluid. Hernia and syringomyelia have certain dangers if left untreated. Common hazards of hernia in children: hernias become embedded, leading to ischemia and necrosis of the intestinal canal and ipsilateral testis, which can lead to infectious shock and endanger life in severe cases; repeated herniation of intestinal contents into the scrotum may lead to testicular dysplasia. The danger of syringomyelia is that it affects the blood supply to the testes and produces testicular dysplasia and even testicular atrophy. So how do you identify a syringomyelia from a hernia? First of all, we should see if the groin and scrotum are symmetrical, and then feel the scrotum with our hands along the groin. If we feel other bags besides the balls, or if the balls on one side look particularly large when we feel them, then we should see a doctor. If the balls are on the top of the scrotum or in the groin, you should also see a doctor to see if it is cryptorchidism. A common method is to shine a flashlight on the enlarged area. A hernia is mostly intestine, which is not translucent, while a syringomyelia is water, which is translucent. So when is it appropriate to operate? For inguinal hernia, if the child does not have frequent herniation of abdominal contents within 1 year of age, the child can be temporarily observed and treated, and surgery can be considered if it does not heal spontaneously after 1 year of age. In cases of frequent herniation of the abdominal contents, surgery is generally recommended after 6 months of age. In children with recurrent herniation, there is no age limit and surgery should be performed as early as possible. In the case of syringomyelia, if the syringomyelia is not large and the tension is not high, there is no urgency for surgical treatment, especially in infants within 1 year of age, as it may still subside on its own. If the tension is high, then early surgery is recommended, regardless of age. If the syringomyelia has not yet resolved on its own beyond 1 year of age, early surgery is recommended to reduce the impact on testicular blood flow and development.