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Hernia in children

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Hernia in children

Hernia in children

Hernia

A hernia is the bulging or protrusion of a portion of an organ through an abnormal opening in the abdominal wall muscles. Normally hernia comes out when the pressure increases and then goes back when the pressure decreases. The danger from hernia arises when the organ protruding through the opening is pinched or constricted to the extent that circulation is stopped or when the protruding organ impairs the function of other structures.

Introduction – Inguinal hernia

Inguinal hernias account for about 80% of all hernias and these hernias appear more frequently in boys than in girls. In the developing baby, the testes initially develop inside the belly near the kidney. The testes drop down to scrotum by 8-9 months of pregnancy. An inguinal hernia results from persistence of all or part of the processus vaginalis, the tube of peritoneum that lays the pathway for the testicle to follow into the scrotum. Following the location of testicles into the scrotum, the processus vaginalis closes automatically and a small portion of it remains as testicular covering called the tunica vaginalis. If the passage remains open, fluid from the abdomen or an abdominal organ itself (usually the intestines) can bulge out and be forced into passage towards scrotum causing a bulging or mass that can be felt. The process vaginalis may extend only partly or completely into the scrotum.

Normal Scrotum

Inguinal Hernia

Normal scrotum: The processus vaginalis and tunica vaginalis are closed and contain no fluid or abdominal contents

Inguinal hernia: The processus vaginalis has remained open allowing abdominal contents (fluid and loops of bowel) to enter into the scrotum

Symptoms & Diagnosis

Usually inguinal hernia does not have any other symptoms except a groin or a scrotal swelling which appears when abdominal organs come out into the sac. Swelling can be seen in the groin area or scrotum when a baby is crying or straining or when an older child coughs, plays, strains or stands for a prolonged time. If the bulging can be easily reduced or pressed back into the abdomen, the hernia is known as a reducible hernia. If the bulge cannot be reduced back, then this is known as an incarcerated (irreducible) hernia. 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 child should be immediately taken to the emergency services.

Treatment

Inguinal hernias in children require a surgery called Herniotomy. This can be done by conventional approach or by laparoscopic means. Surgery is done under a short general anesthesia. This is mostly a Day Care Surgery whereby the child is admitted in the morning and discharged in the evening. All the stitches are absorbable and need not be removed.

Can inguinal hernia be repaired laparoscopically in children?

Yes, hernia can be operated laparoscopically easily even in small kids. For this purpose we use 3mm small equipment and telescope. We generally offer laparoscopic hernia repair to selected circumstances only after a detailed discussion with the family. Straightforward indications of Laparoscopic hernia repair are – bilateral hernia, recurrent hernia after a failed repair and a girl child with suspected internal organ problems.

Are any tests required for diagnosing or treating hernia?

The diagnosis of hernia is made clinically by a thorough examination. Most of the times further testing is not required.

Routine blood tests and a simple urine test is done for assessing fitness for surgery.

Can hernia occur again?

Recurrence of hernia is rare in hands of experienced surgeons. There is 5% chance of hernia appearing on the other side when one sided hernia is operated. This primarily occurs as the defect leading to hernia on one side may be already there on the other side too but clinically not significant initially. This may manifest clinically anytime in the coming few years. Routine both sided surgery for one sided hernia is no longer recommended as 19 children will have to be operated to prevent hernia per one child.

Can hernia occur in girls?

Inguinal hernias can occur in girls and girls comprise about 10% of all children coming to the clinic with hernias. With girls, an ultrasound is mandatory before surgery to rule out any internal problems like malformation or absence of internal reproductive organs. Rarely, a karyotype may be required if any such issues is suspected on ultrasound.

Clinical picture of a small boy with inguinal hernia on the left side

Testimonials

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Kranti Tandel profile picture
Kranti Tandel
2 months ago
From the moment I walked into the hospital until the day I was discharged, I felt genuinely cared for.

A heartfelt thank you to Dr. Manish Dubey for making such a stressful time feel so much easier. His calm nature, patience, and the way he explains everything instantly put me at ease. They say half the healing begins when you trust your doctor, and that’s exactly how I felt with him. The procedure was far less painful than I had imagined, and I truly believe that’s because of his skill and the confidence he gives his patients.

The nursing staff was absolutely wonderful
kind, compassionate, attentive, and always there whenever I needed help. Every member of the hospital and hospitality staff treated me with warmth, respect, and genuine care, which made all the difference during my recovery.

It’s rare to find a team that is not only excellent at what they do but also so humane and compassionate. Thank you to Dr. Manish Dubey and the entire team for making my journey so comfortable. I will always be grateful and would wholeheartedly recommend this hospital to anyone looking for exceptional medical care.
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Shilpa Nair profile picture
Shilpa Nair
4 months ago
I had an excellent experience and am very grateful for the care and support I received. The entire staff was professional, friendly, and attentive, making me feel comfortable throughout the process.

A special thank you to Dr. Vijaykumar Yadav for his expertise, patience, and compassionate approach. He took the time to explain everything clearly and ensured that all my concerns were addressed. His dedication to patient care is truly commendable.

I highly recommend this place to anyone seeking quality treatment and outstanding service. Thank you once again, Dr. Vijaykumar Yadav, for your exceptional care!
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Mahendra Patil profile picture
Mahendra Patil
4 months ago
My 3 years 11 month year old daughter was diagnosed with 10 mm kidney stone Dr.A.k.Singhal,Dr.Manish Dubey,and Dr.Ashwita Shenoy performed the surgery to remove the stone on May 30th with immense success. I am deeply grateful for the exceptional care and professionalism demonstrated by this entire team.
From the very beginning,the doctors explained every detail of the treatment process with great patience and clarity, this provided us as parents with immense relief and put our minds completely at ease. The surgery proceeded very smoothly and thanks to the doctors expertise and dedication my daughter is now completely healthy and in excellent health
I would also like to extend my special thanks Dr.A.k. Singhal , Dr. Ashwita Shenoy for providing us with constant support and guidance throughout this entire process.they were always available to answer our questions and ensured that our daughter received the very best treatment . Thank you mitra hospital. Thank you so very much for taking such excellent care of my daughter and for making this difficult time for our family SO much more bearable.
और
मेरी बेटी को left inguinal harniya भी hua था उसकी भी सर्जरी करणी जरुरी थी और DJ स्टेट removal भी करना था june 20 th को मेरे बेटी का Dr. Ashwita Shenoy मॅडम ने left inguinal harniya की surgery बहुत आछी तरह की और DJ स्टेट भी निकाली मेरे बेटी का सब अच्छा हुवा thank you mitr hospital All team thanks Dr. Ashwita Shenoy मॅडम मेरे परिवार के तरफ से आपको और आपके पुरे टीम को धन्यवाद.
excellent treatment my daughter
Thank you mitr hospital
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Purva Shingare profile picture
Purva Shingare
4 months ago
Had kidney stone surgery done by Dr Manish Dubey. All staff was cooperative. Doctor Dubey made me so much relaxed that I was not at all worried about the procedure. Other doctors in the OT were also very sweet. The staff is very nice, hospital is clean ,no smell of medicines, housekeeping services are very good. Hospital food is also very nice,tasty and healthy. Insurance procedure is also very easy. The surgery procedure went so smoothly. I would surely recommend Mitr Hospital and special thanks to Dr Dubey.
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Nikita Ghodke profile picture
Nikita Ghodke
6 months ago
I had an amazing experience at the hospital, which offers excellent facilities and truly stands out in terms of care and support. I was under the treatment of Dr. Vijaykumar Yadav, who is exceptional in his field. His kindness, compassion, and dedication to his work made a significant difference throughout my journey.
He is highly detail-oriented and experienced, ensuring I felt confident and well-informed at every step. I underwent two surgeries, and he consistently reassured me and focused on my recovery and well-being. What truly sets him apart is his availability, he was always there whenever needed, even late at night.
Overall, the hospital is outstanding and undoubtedly one of the best in Navi Mumbai. I’m truly grateful for the care I received.
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Dimple Choudhary profile picture
Dimple Choudhary
1 year ago
Very polite staff N great service ☺️
Ketan Bhagat profile picture
Ketan Bhagat
1 year ago
Excellent,
We had a nice experience with Mitr hospital. Dr.A.K.Singal is such a talented Child urologist and nice person. Staff are good. Thank you so much Dr.A.K.Singal sir and Dr.Ashvitha Mam for treating our daughter so well and saving her life.. We w'l be gratful to you throughout our life..
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Pankaj Choudhary profile picture
Pankaj Choudhary
1 year ago
Very experienced Doctor and cooperative staff. They give full time to patients for there Query and problems.

Blood test Camp organised for Woman's day was support and very helpful
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Sneha Omale profile picture
Sneha Omale
1 year ago
डॉ. अमित घरत इंडॉस्कॉपी खूप छान पध्दती ने केली . धन्यवाद डॉक्टर आणि त्यांची टीम . वेळोवेळी मदत केली बद्दल.
prathamesh palkar profile picture
prathamesh palkar
1 year ago
“I am extremely grateful for the excellent service provided by Mr.Aditya Sir from the hospital TPA insurance team. He was incredibly professional, patient, and thorough in explaining my insurance coverage and guiding me through the entire process. His prompt assistance and dedication made everything smooth and hassle-free. I truly appreciate his kindness and efficiency in handling my queries. Thank you, Aditya Sir, for your outstanding support!”
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