Inguinal Hernia in Children

ByJaime Belkind-Gerson, MD, MSc, University of Colorado
Reviewed/Revised Nov 2023
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A hernia is a protrusion of a piece of the intestine through an abnormal opening in the abdominal wall. An inguinal hernia occurs in the groin (the inguinal area).

  • A piece of intestine protrudes through a hole in the groin.

  • Typically, children develop a painless bulge in the groin or scrotum.

  • The diagnosis is based on an examination and imaging tests.

  • Usually, the hernia is repaired surgically.

(For adults, see Inguinal Hernia.)

A hernia in the groin is called an inguinal hernia (see figure What Is an Inguinal Hernia?). Inguinal hernias are more common among boys, particularly those who are premature. The right side is affected most commonly, and about 10% of inguinal hernias occur on both sides of the groin.

An inguinal hernia extends into the groin and can extend into the scrotum. With an inguinal hernia, the opening in the abdominal wall can be present from birth or develop later in life.

What Is an Inguinal Hernia?

In an inguinal hernia, a loop of intestine or another abdominal organ pushes through an opening in the abdominal wall into the inguinal canal. The inguinal canal contains the spermatic cord, which consists of the vas deferens, blood vessels, nerves, and other structures. Before birth, the testes, which are formed in the abdomen, pass through the inguinal canal as they descend into the scrotum.

Symptoms of Inguinal Hernia

Inguinal hernias usually cause a painless bulge in the groin or scrotum.

Complications of inguinal hernia

Sometimes a portion of the intestine is trapped in the scrotum (called incarceration), and the bulge may become firm, tender, swollen, and the skin may be red.

If the intestine becomes trapped, the intestine’s blood supply can be cut off (called strangulation). A strangulated hernia causes steady, gradually increasing pain, typically with nausea and vomiting. The bulge is tender, and the skin may be red. Strangulated intestine may die (develop gangrene) within hours, so this condition is an emergency.

Diagnosis of Inguinal Hernia

  • A doctor's examination

  • Sometimes imaging tests

Doctors base the diagnosis on an examination.

Sometimes the doctor does ultrasonography to help make the diagnosis.

Treatment of Inguinal Hernia

  • Surgical repair

If the hernia is strangulated or incarcerated, surgery is done immediately.

If the hernia is not causing symptoms, doctors usually advise surgery because inguinal hernias can become incarcerated. Before surgery, doctors may try to push the intestine back into place by hand (called manual reduction).

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