An inguinal hernia is one of the most common conditions pediatric surgeons treat. While the word “hernia” can sound alarming, this is a well understood issue with a surgery and a smooth recovery for most children. Knowing what to look for and when to seek care can help parents feel confident if they find out their child has one.
What is an inguinal hernia?
An inguinal hernia happens when a small opening in the lower abdominal wall allows tissue, often part of the intestines, to push through into the groin area. In younger children, this opening can be present at birth.
You might notice a soft bulge in your child’s groin that appears when they cry, cough, strain or stand and may seem to go away when they are calm or lying down.
Signs and symptoms parents may notice
- A visible bulge in the groin or scrotum (for boys)
- Swelling that comes and goes
- Fussiness or discomfort, especially with crying or straining
- A feeling of fullness in the groin
- In older children, reports of groin pain or pressure
If the bulge becomes firm, painful, red or does not go away, this can be a sign the hernia is trapped. This is urgent and requires immediate medical attention.
Why surgery is recommended
Unlike some conditions that children outgrow, an inguinal hernia will not close on its own. Over time, there is a risk that a portion of the intestine can become stuck in the opening. This is called incarceration (trapped hernia) and can lead to loss of blood flow to the intestine. Surgery prevents this complication and is considered the standard, best treatment.
When is hernia repair done?
Once an inguinal hernia is diagnosed, pediatric surgeons usually recommend scheduling repair soon after. The exact timing can depend on your child’s age, symptoms and overall health. In babies, the timing of a repair can vary. The risk of a trapped hernia can be higher, but also needs to be weighed with the risk of anesthesia. Your child’s surgeon will talk with you about the safest timing for surgery.
Types of repairs: Open and laparoscopic
Pediatric surgeons may repair an inguinal hernia using one of two approaches.
Open repair
- A small incision is made in the groin.
- The hernia contents are gently moved back into place.
- The hernia opening is closed with stitches.
Laparoscopic repair
- One to two very small incisions are made.
- A tiny camera helps guide the repair from inside the abdomen.
- The opening is closed internally with stitches.
Both approaches are safe and effective. The choice depends on your child’s age, internal structure and the surgeon’s recommendation. In some cases, laparoscopy is also used during open repair which allows the surgeon to check for a hernia on the other side at the same time.
Outpatient surgery and what to expect
Inguinal hernia repair is typically done as an outpatient surgery. This means your child goes home the same day. The procedure is performed under general anesthesia. Most surgeries take less than an hour.
Parents can expect:
- A few hours at the surgical center
- Mild groin soreness for a few days
- A small bandage or surgical glue over the incision site
Recovery at home
Children usually recover quickly after hernia repair. Your surgery team will give you specific instructions based on your child’s age and procedure, but generally:
- Infants and young children often return to normal activity within a day or two.
- Older children may need to avoid rough play or sports for a short period.
- Pain is usually managed with over-the-counter medication.
- Incisions are normally small and heal well with minimal scarring.
Reassurance for parents
Hearing that your child needs surgery can feel overwhelming. The good news is that inguinal hernia repair is one of the most common and successful pediatric surgeries performed today. With timely care and a straightforward recovery, most children are back to their normal routines very quickly.
If you notice a groin bulge or have concerns about a possible hernia, your pediatrician can help guide you to the next step in care.
Make an appointment
If you think your child may have a hernia or you have questions about treatment, our pediatric surgery team is ready to help. WashU Medicine pediatric surgeons, including Patrick A. Dillon, MD, specialize in caring for children with inguinal and other hernias. To schedule an appointment, please call 314-454-6022 or visit our website.