Hernias in children

Introduction

This leaflet explains hernias and what to expect when your child comes to either the Chelsea  and Westminster Hospital or West Middlesex University Hospital for their operation.

What is a hernia?

A hernia describes a small piece of abdominal lining, and sometimes a section of the bowel, which bulges out through a weak area in the muscles of the abdominal wall. Both children and adults can have hernias. Sometimes it is present at birth. The hernia can look bigger when your child cries or strains. You may hear your child's hernia referred to as an 'inguinal hernia' or a 'femoral hernia'. These names refer to the exact part of your child's abdomen which have the muscle weakness. Both types of hernia are treated in the same way.

How common are hernias in children?

Hernias are more common in boys than girls. About one in 50 boys will have a hernia during their childhood. The condition is also more common in babies born prematurely.

Is it possible to prevent a hernia?

There is no known way of preventing a hernia.

How is a hernia diagnosed?

Your doctor will be able to diagnose the hernia by clinical examination as it appears as a characteristic lump in your child's abdomen. Your child may not need any further diagnostic investigations.

How are hernias treated?

Your child will need a small operation. In many cases this can be carried out as day surgery - your child will arrive at the hospital, have the operation and be able to go home on the same day. Occasionally a child will need to stay in hospital for two or three days.

What happens before the operation? 

You will receive information about how to prepare your child for the operation in your admission letter/email. Your child should not have anything to eat or drink beforehand for the amount of time specified in the letter. It is important to follow these instructions - otherwise your child's operation may need to be delayed or even cancelled.

The day you come to hospital for the operation, your child's surgeon will explain the operation in detail, discuss any worries you may have and ask you to sign a consent form. An anaesthetist will also see you to explain your child's anaesthetic in more detail. If your child has any medical problems, such as allergies, please tell the doctors.

What does the operation involve?

Your child will be given a general anaesthetic and will be asleep during the operation. The surgeon will make a small incision over the bulge in the groin or pass a scope through the tummy button and repair using keyhole surgery instruments. The abdominal lining and piece of bowel will be pushed back into place.  If the incision is in the groin a small telescope may be passed through the hernia (laparoscopy or keyhole surgery) in order to identify the presence or absence of another hernia on the other side. This occurs in 1 in 10 children. If this is the case another incision will be made on the opposite side. The muscle wall beneath one/ both groin cuts will be repaired and the cut will be closed with stitches. These stitches will dissolve and will not have to be removed. A glue will be placed over the incision.

Are there any risks?

Every anaesthetic carries a risk of complications, but this is very small. Your child's anaesthetist is an experienced doctor who is trained to deal with any complications. After an anaesthetic, a child sometimes feels sick and vomits, has a headache, sore throat or feels dizzy. These effects are usually short-lived. Any surgery also carries a small risk of infection or bleeding.

What happens afterwards?

After the operation, your child may feel some tenderness and have bruising in the groin area.

If your child feels uncomfortable, a painkiller such as liquid paracetamol will help. It's a good idea for your child to wear loose clothing while the area is sore. Babies can wear nappies as usual. You can give your child a bath two days after the operation. However, avoid long baths until the wound has settled down. Do not use cream around the wound as it may cause irritation.

Your child's surgeon may ask you to come back for an outpatients appointment.

Are there any long term effects of hernia repair?

More than 99% of hernia repair operations are successful. You should see an immediate reduction or the complete disappearance of the hernia.