Inguinal Hernias
I had a 21 month old male patient who came in for bulging in his right inguinal area.
By physical exam, I told the mother that most likely we are dealing with an inguinal hernia.
So, we did an ultrasound on his inguinal area (bilateral side) and he was referred to a surgeon for assessment and management.
Inguinal hernias result from failure of the processus vaginalis to close before birth and the patency is sustained by the abdominal pressure after birth.
Right- sided hernias are more common than on the left. The most common complaint is the presence of a mass of varying size in the inguinal region and that more prominent when the baby is crying hard.
It is usually present without other symptoms but in severe cases may have pain, irritability, nausea and vomiting.
The most serious complication of inguinal hernia is incarceration. This is manifested as:
– appearance of a firm, tender, globular, irreducible swelling below the external ingiinal ring
– the baby is irritable and fretful
– with vomiting, abdominal distension and feverish
As soon as the diagnosis is made, it is good to do surgery to repair the defect and to avoid the serious complication which is incarceration.
Going back to our case, the baby underwent surgery and when i came to visit him, he was up and about and was happy as well as the mother.