Advertisement

Pediatric Inguinal Hernia

  • Afif N. Kulaylat
  • Kathryn Lynn MartinEmail author
Chapter

Abstract

Inguinal hernias in children are a result of failure of the processus vaginalis to obliterate leading to herniation of abdominal contents through the internal ring and into the inguinal canal. Most children are asymptomatic at presentation; however, some will present with acute incarceration with risk of strangulation. Diagnosis is based on physical examination. Ultrasound may occasionally rarely be helpful. Treatment is surgical with ligation of the hernia sac at the level of the internal ring. This can be completed electively unless the hernia is unreducible there is concern for incarceration or stangulation, at which time emergent repair is required. Inguinal hernia repair may be completed through an open or laparoscopic approach, based on surgeon preference. Assessment and repair of an asymptomatic contralateral patent processus vaginalis remains controversial.

Keywords

Inguinal hernia Patent processus vaginalis Inguinal canal Incarceration Strangulation 

References

  1. 1.
    Lao OB, Fitzgibbons RJ Jr, Cusick RA. Pediatric inguinal hernias, hydroceles, and undescended testicles. Surg Clin North Am. 2012;92(3):487–504, vii.CrossRefGoogle Scholar
  2. 2.
    Zamakhshary M, To T, Guan J, Langer JC. Risk of incarceration of inguinal hernia among infants and young children awaiting elective surgery. CMAJ. 2008;179(10):1001–5.CrossRefGoogle Scholar
  3. 3.
    Sameshima YT, Yamanari MG, Silva MA, Neto MJ, Funari MB. The challenging sonographic inguinal canal evaluation in neonates and children: an update of differential diagnoses. Pediatr Radiol. 2017;47(4):461–72.CrossRefGoogle Scholar
  4. 4.
    Zani A, Eaton S, Hoellwarth M, et al. Management of pediatric inguinal hernias in the era of laparoscopy: results of an international survey. Eur J Pediatr Surg. 2014;24(1):9–13.PubMedGoogle Scholar
  5. 5.
    Esposito C, Escolino M, Cortese G, et al. Twenty-year experience with laparoscopic inguinal hernia repair in infants and children: considerations and results on 1833 hernia repairs. Surg Endosc. 2017;31(3):1461–8.CrossRefGoogle Scholar
  6. 6.
    Miyake H, Fukumoto K, Yamoto M, et al. Risk factors for recurrence and contralateral inguinal hernia after laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia. J Pediatr Surg. 2017;52(2):317–21.CrossRefGoogle Scholar
  7. 7.
    Gause CD, Casamassima MG, Yang J, et al. Laparoscopic versus open inguinal hernia repair in children </=3: a randomized controlled trial. Pediatr Surg Int. 2017;33(3):367–76.CrossRefGoogle Scholar
  8. 8.
    Zhao J, Chen Y, Lin J, et al. Potential value of routine contralateral patent processus vaginalis repair in children with unilateral inguinal hernia. Br J Surg. 2017;104(1):148–51.CrossRefGoogle Scholar
  9. 9.
    Centeno-Wolf N, Mircea L, Sanchez O, et al. Long-term outcome of children with patent processus vaginalis incidentally diagnosed by laparoscopy. J Pediatr Surg. 2015;50(11):1898–902.CrossRefGoogle Scholar
  10. 10.
    Weaver KL, Poola AS, Gould JL, Sharp SW, St Peter SD, Holcomb GW 3rd. The risk of developing a symptomatic inguinal hernia in children with an asymptomatic patent processus vaginalis. J Pediatr Surg. 2017;52(1):60–4.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Surgery, Division of Pediatric SurgeryPenn State Milton S. Hershey Medical CenterHersheyUSA

Personalised recommendations