A Visible Lump In The Groin Of Baby? All About Inguinal Hernia In Babies

Hernia among kids is fairly common than you think. Babies, especially preemies are even born with a hernia. Babies can contract different types of hernia. Here we are dealing with one of the common type of hernia the baby contracts - Inguinal Hernia.

What is an inguinal hernia?

When part of an organ or tissue within the abdomen,  such as a part of the intestine, pushes through the weakest spot in a muscle wall and bulge out into space where it does not belong, it is referred as a hernia. A  baby may be born with a hernia, or baby can develop in the first few months or even a child could contract it in later, childhood or adulthood.

An inguinal hernia is a hernia that happens in the groin area. Even though it can affect both boys and girls, boys are four to eight times more likely than girls to contract it In boys, an inguinal hernia can stretch into the scrotum. While it affects one to five percent of full-term babies, it is more common in preemies, 7-30%.

What causes an inguinal hernia in babies?

In boys, an inguinal hernia related to the development and descent of the testes. The testis is developed inside the abdomen of the fetus. It is around the seventh month of pregnancy, the testes start to descend to the scrotum. After they reach the scrotum, the opening behind should close. Failure of closing this opening in proper time can pave the way for developing hernia.

In girls, a similar process happens as the round ligament of the uterus descends into the groin at the labia, the loose skin at the opening of her vagina. The sac that formed usually closes shortly after birth, thereby, eliminating the connection between the abdominal cavity and the groin. However, once the closure of the process vaginalis is delayed or incomplete, a loop of the intestines can push through the abdominal wall into the child's groin area all the way into her labia developing a hernia.

How can I know my baby is having an inguinal hernia?

Swelling/ bulging:

The swelling in the groin area is the characteristic sign of an inguinal hernia in babies. The swelling, even though may cause some discomforts,  will be usually painless. It will be soft and smooth in texture.

  • A swelling appears in the groin.
  • A swelling in the scrotum.
  • The swelling disappear or reduce in size when baby is relaxed and lying flat
  • The swelling may appear or increase in size when the baby is crying, coughing or straining.

What are the types of an inguinal hernia in babies?

There are two types of Inguinal Hernia – Reducible and irreducible (incarnated)

If the part of the bowel that is bulged out returns to the abdomen if pushed back, it is relatively harmless hernia tagged as a reducible hernia. Sometimes tissue can become trapped in an opening or pouch and not able to draw back. These are incarcerated hernias and it is a serious issue that requires immediate medical attention. Incarnated hernia if left untreated soon can develop into a strangulated hernia, in which the normal blood supply is cut off from the trapped tissue which is not usual in the inguinal type of hernia.

What are the symptoms of an incarcerated inguinal hernia?

  • Baby looks ill
  • Pain in the groin area
  • Nausea and vomiting
  • Fever
  • The lump suddenly turns larger, harder, or darker.
  • The bulge that does not change its size while crying

Treatment options:

  • If the hernia is reducible, the doctor may attempt to reduce it by applying pressure to the hernia to return the contents back into the abdomen.
  • If the hernia is irreducible, it can develop into a strangulated hernia. In such cases, urgent surgical treatment at a pediatric specialist hospital is required.

If not treated promptly:

Even a simple hernia carries a risk because, in the meantime, it can turn out incarnated. If an incarnated hernia is not treated fairly quickly, it can lead to immediate life-threatening issues like bowel obstruction, bowel perforation, and even death.

If the treatment is delayed, the testes in the male and the ovaries in the female can have the blood supply cut off, and therefore undergo permanent damage.

What are the risks associated with the surgery?

Just like any other surgical procedure, the surgery performed for an inguinal hernia has been also not 100% risk-free. There are risks of

  • Side-effects from the anesthetic, wound infection and bleeding
  • Injury to the testicle
  • Damage to the vas deferens, the tube that carries sperm from the testicle

What happens after the surgery?

Hernia repair is usually a day procedure, and the baby is discharged on the same day itself. However,  the child may need to stay overnight in the hospital for observation in some circumstances like:

  • The baby is under 6 weeks old
  • The hernia was incarcerated and the surgery was difficult.
  • If the child has a pre-existing illness