Inguinal hernia (peds)

Background

  • 1-2% of children have these
    • 10% become incarcerated
      • 70% of incarceration occurs in infants (usually <6 mo)
  • Male:Female ration = 6:1
  • 21% of female inguinal hernias contain an ovary!

Clinical Features

  • Parents usually report bulge in scrotum or groin that increases with crying
  • Lack of transillumination indicates incarcerated hernia vs hydrocele (usually no change with crying)

Differential Diagnosis

Pediatric Abdominal Pain

0–3 Months Old

3 mo–3 y old

3 y old–adolescence

Testicular Diagnoses

Evaluation

  • Clinical diagnosis
  • Ultrasound for confirmation

Management

  • 95% can be reduced without surgery using gentle firm continuous pressure, Trendelenberg, & analgesics
  • Surgery consult or follow up if cannot reduce. Ensure no obstruction.

Disposition

See Also

Abdominal pain (peds)