Pediatric inguinal hernias are common in pediatric surgery, with an incidence rate of 0.8-4.4%, and are somewhat more likely to occur in boys than in girls, especially in premature infants, where the incidence can reach 30%.
If left untreated, it can lead to hernia intussusception or intestinal perforation and, in severe cases, may lead to dysplasia of one testicle or ovary, causing permanent dysfunction and affecting the function of the reproductive system.
Pediatric inguinal hernia, the most common disease in pediatric general surgery, is mainly caused by some children born with weak areas where the groin does not close well, resulting in the small intestine, omentum, ovaries and fallopian tubes in the abdominal cavity leaving their original position and protruding from the groin, which becomes a hernia.
In children with inguinal hernia, most of the time, the protrusion can be observed at the base of the thigh, i.e. in the groin, especially when the pressure on the child’s abdomen increases, such as crying and defecation, the protrusion becomes more obvious. However, there are times when the protrusion is not obvious or even invisible.
Therefore, parents should pay attention to the observation and take a picture when the protrusion is more obvious, so that when they take their child to the doctor, they can help the doctor to make a better diagnosis of the child’s condition.
Pediatric inguinal hernia, if left untreated, can have the following risks.
1. The child will experience abdominal pain, abdominal distention, vomiting, etc. ;
2. organs such as small intestine and omentum that have left their original position cannot be restored to their original position in time, and insufficient blood supply occurs, affecting their function, a condition called hernia impaction;
3. In serious cases, ischemic necrosis of the intestine, intestinal perforation and acute peritonitis may occur, which may endanger life;
4. In boys, inguinal hernia may enter the scrotum and compress the testicles, causing insufficient blood supply to the ipsilateral testicles and affecting their development and function;
5. In girls, if it is the ovaries or fallopian tubes that leave the abdominal cavity, it may lead to ischemic necrosis of the ovaries or fallopian tubes.
The chance of spontaneous healing of inguinal hernia in children is very low, only 1 %, which is much lower than the chance of complications 28 %. Therefore, surgery should be performed as early as possible, with the following implications.
1. Prevent ingrown hernia: Dr. Jacobs, chief of surgery at Toronto Hospital, found from clinical experience that children who underwent surgery within two weeks of finding a hernia were half as likely to have an ingrown hernia compared to children who were observed for 30 days after having a hernia.
2. Preventing a hernia on the other side: Bilateral hernias have a 10% chance of occurring. In addition to treating the hernia that has already occurred, the surgeon can also check for the possibility of a hernia on the other side and repair it in time.
3. Prevent recurrence: The surgeon will also check for other factors that may have caused the hernia, such as an undescended testicle, to avoid recurrence of the hernia.
With the spread of laparoscopic surgery, surgeons can treat pediatric hernias with this minimally invasive surgical approach. This surgery is minimally invasive and has a short recovery time.
Risks of inguinal hernia surgery
The technique of inguinal hernia surgery is relatively mature and complications are less likely to occur if the surgeon has extensive experience and is routinely trained. However, it is also necessary for parents to be aware of the possible risks of.
1. temporary swelling of the surgical site, especially if the hernia repair area is large, but this will disappear as the child recovers;
2. Infection of the wound;
3. damage to the blood vessels at the surgical site;
4. Recurrence of the hernia.
Children with no post-operative complications can usually be discharged on the same day as the surgery, but parents need to bring their children for a follow-up visit one week after the surgery.