Pediatric Surgery Specialist Prof. Dr. Feryal Gün Soysal explained what you need to know about the treatment of inguinal hernias in children.
A hernia is the protrusion of an organ in the abdomen (such as the intestines) through the abdominal wall. A soft mass is palpable where the hernia is located. A hernia that occurs in the groin area is called an inguinal hernia. While in the womb, babies' ovaries (testes in boys, ovaries in girls) are located in the abdomen, close to the kidneys. As the baby develops, the ovaries descend towards the groin area. As the male ovary descends into the sac (scrotum), it drags a sac made of the membrane covering the inside of the abdomen, called the peritoneum, towards the inguinal canal. The canal cannot close in this way and the sac inside it causes hernia formation. In girls, the uterine ligaments pass through the same canal. With a similar mechanism, a membrane sac is formed in the inguinal canal. After all; This sac, which is present at birth, may not be noticed because it is very thin. It is only noticed by the family and the doctor when an organ such as the intestines enters it. Sometimes only water enters this sac, this condition is called "hernia-like blister" (hydrocele).
It is more common in boys
Inguinal hernia % It is seen in boys at a rate of around 80-90. Inguinal hernia can occur on one side, or it can be detected on both sides at a rate of approximately 10%. Its incidence in premature babies is three times higher than in normal weight babies. It can usually occur within the first 6 months. It is also possible for it to occur in later ages.
Inguinal hernia seen in children is not related to strain as in adults; genetic factors play a role. Inguinal hernia manifests itself with a swelling in the groin or bag when the child cries and strains. Inguinal hernia in babies, which can cause serious problems when intervened late, can be completely eliminated with correct diagnosis and treatment.
How is it treated?
Inguinal hernia, intra-abdominal hernia. It should be treated with surgical techniques as soon as possible to prevent the risk of organs being squeezed and suffocated. Due to the risk of anesthesia in premature babies, a wait of one or two months may be required. The surgery is performed under general anesthesia. In the groin area A small incision is made, and after the hernia sac is repaired, the skin incision is closed with dissolvable stitches. The incision is covered with a small dressing.
After the surgery, except for premature and newborn babies, children are started on liquid food shortly after the surgery and sent home. There is usually no need for activity restrictions. It is recommended to avoid strenuous sports activities in older children. There may be swelling in the surgical area and in the bag due to the procedure, but these swellings normally disappear slowly within 1-2 months. Recurrence may occur in some disease groups such as connective tissue and premature babies. In a unilateral inguinal hernia, a hernia may occur on the opposite side later. Especially if there is an inguinal hernia on the left side, a very high rate of hernia may occur on the right side. In this case, re-operation is mandatory.
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