A hernia is the bulging of a portion of an organ through an abnormal opening. The danger from herniation arises when the organ protruding through the opening is constricted to the extent that circulation is stopped or when the protruding organ impairs the function of other structures.
Inguinal hernias account for about 80% of all hernias and are the most common surgical procedures done in infancy. These hernias appear more frequently in boys than in girls. An inguinal hernia is derived from persistence of all or part of the processus vaginalis, the tube of peritoneum that precedes the testicle into the scrotum during the eighth month of pregnancy. Following the dropping of the testicles into the scrotum, the processus vaginalis withers and closes forming the tunica vaginalis that lies below the testicles in the scrotum. When this fails to happen, fluid from the abdomen or an abdominal organ (usually the intestines) can be forced into it causing a bulging or mass that can be felt. The process vaginalis can extend only partly from the inguinal canal or extend completely into the scrotum.
There are usually no symptoms that a child has an inguinal hernia until abdominal organs are forced into the sac. Swelling can sometimes be seen in the groin area when a baby is crying or straining or when an older child coughs, strains or stands for a long time. If the bulging can be gently pressed back into the abdomen, the hernia is known as reducible. If a loop of the intestine is forced into the sac, the hernia is then known as incarcerated (irreducible). An infant or a child will show signs of irritability, loss of appetite, tenderness and swelling of the abdomen or have trouble having a bowel movement. With incarceration, the intestines have entered the sac and are being strangled. This portion of the intestines could die. This is life-threatening and you should call us immediately.
Most children are awake after their procedure, however, some children may remain sleepy for hours. Your child will be able to go home when he or she is awake, able to drink, and has a normal heartbeat and breathing patterns. Your child will have a small incision in the groin where the hernia was once located. The incision does not require any special care after the procedure, however, you may want to avoid dressing your child in clothing that fits snugly over this area. A small gauze bandage can be used to protect the incision from being irritated by clothes.The stitches will dissolve on their own and do not need to be removed. The strips of tape placed over the incision to help the skin heal smoothly with minimal scarring will peel off within five to 10 days. It is important to have this tape in place to ensure proper healing – please do not pull it off. There also may be bruising in the groin around the incision and bruising and swelling in the scrotum. This is normal and will go away within one to two weeks.The Steri-StripsTM on your child’s incision should remain in place and kept dry until they fall off on their own, usually in seven to 10 days. Give your child sponge baths until the dressing is removed.Your child may need pain medicine the first few days after surgery for pain control. Your child’s care team will provide you with prescriptions and specific instructions on administering your child’s medications in the recovery room prior to discharge.Your child should avoid rough play for several days, but can resume most normal activities as soon as he or she feels well enough. Your child should not ride on straddle toys or bicycles for a week. School-aged children can return to school within three to four days.
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