Inguinal hernia is a common condition in children that results in a bulge in the lower abdomen and may be painful. Fortunately, the hernia is not dangerous, but its complications can be serious. Therefore, it is better to undergo inguinal hernia repair surgery, as it is the only solution for this condition.

Inguinal hernia occurs in the inguinal region, which is the area between the lower abdomen and the upper thigh, when a part of the intestines slips into the goin instead of staying in the abdomen where it should be. Professor Dr. Wael Ghanem, a consultant plastic surgeon and congenital defect repairer, repairs an inguinal hernia surgically, preventing the intestines from remaining trapped in the groin. A blockage in the blood flow to the trapped intestines can occur, leading to tissue damage, which is considered a medical emergency. Doctors should treat the hernia before it becomes an emergency.

Inguinal hernia is more common in boys, but girls can also develop it. Prematurely-born children are more prone to developing inguinal hernias.

 

The main sign of an inguinal hernia is a visible bulge under the skin in the groin or scrotum. The child may have swelling on one side of the thigh or both sides.

Other signs may include:

• Pain, especially when bending, straining, lifting, coughing, or crying.

• Pain that improves with rest.

• Weakness or pressure in the thigh.

• In boys, swelling or enlargement of the scrotum.

• A burning sensation or pain at the site of the bulge.

 

• The hernia may increase when the child does something that creates abdominal pressure, such as standing, crying, coughing, or straining for a bowel movement.

• The hernia may become smaller again when the child lies down and calms.

The hernia may only be visible when the baby cries, coughs, or defecates. Parents may also notice that the child eats less than usual.

 

There are different types of inguinal hernias. The most common type occurs in infants and young children when the intestines slide into a pathway called the inguinal canal in the thigh instead of staying in the abdomen.

When a baby boy develops in the mother's womb before birth, the testicles move from the abdomen to the scrotum through the inguinal canals. These pathways should close before birth. If these canals remain open, the baby's intestines can slide into the inguinal canal and the scrotum, causing a hernia. Girls do not have testicles, but they have inguinal canals, so they can also develop inguinal hernias.

An inguinal hernia can also occur when the abdominal muscles become weak, allowing the intestines to protrude, causing a hernia.

 

• Pain, vomiting, and continuous crying.

• The occurrence of suffocation in the hernia area, which is the interruption of the blood supply to the internal organs inside the hernia, which causes pain, redness, and a rise in the child's temperature.

The trapped internal organs can be fat, part of the intestines, or one of the ovaries in the case of a female child, which may lead to the complete loss of the ovary with the fallopian tube and a 50% decrease in her chances of conceiving.

 

• A clinical examination of the child is the diagnostic method if the child is experiencing any pain or swelling in the thigh or scrotal sac. Dr. Wael Ghanem examines the inguinal canal area and can observe the hernia bulge through that canal.

• When the child stands up, there is a difference between the two inguinal areas, with one side protruding more than the other. Therefore, the doctor may ask the child to stand and cough.

• Signs of intestinal obstruction and inguinal hernia may appear as a hard and painful mass.

• The doctor also asks about the child's medical history.

• The diagnosis of intestinal obstruction can be done through X-rays (abdomen X-ray).

 

Inguinal hernias are only treated surgically through inguinal hernia repair surgery without other treatment methods.

Inguinal hernia repair surgery is one of the most common types of surgery performed on children. Surgical intervention is necessary to prevent the worsening of the inguinal hernia and damage to the intestines.

 

1. The child is completely anesthetized to prevent any pain.

2. Dr. Wael Ghanem makes a small incision in the navel to insert the laparoscope. In boys, the hernia is moved away from the spermatic cord, which carries blood to the testicle and represents the path of the sperm. Then the contents of the hernia are returned to the abdominal cavity.

3. The surgeon strengthens the abdominal wall by suturing it to help prevent another hernia and using mesh to reinforce the wall through an incision in the lower abdomen.

4. The surgeon closes the incision cosmetically.

 

Most children have this gap on the other side as well. Therefore, the surgeon performs the hernia repair surgery on the other side, even without an inguinal hernia, to prevent the occurrence of an inguinal hernia.

Inguinal hernia repair surgery is distinguished by the absence of surgical marks due to its distinct location in the lower abdomen.

The treatment of inguinal hernia strangulation is performed through safe surgical intervention and advanced techniques with Dr. Wael Ghanem, a consultant of plastic surgery and congenital defect repair. The surgeon removes the portion of the intestine experiencing strangulation and necrosis and then proceeds with the steps of hernia repair.

 

Most children can return home a few hours after the surgery, and here are the important information to know:

• It is necessary to give the child the prescribed medication and pain relievers as directed.

• The child may experience some swelling and bruising near the surgical area. Boys may have swelling in the scrotum. Applying cold compresses (a frozen pack or an ice bag wrapped in a towel) to the swollen area can help reduce swelling.

• Some children may experience constipation and difficulty with bowel movements after the surgery. They need to consume plenty of fluids, such as water, peaches, pears, and apple juice. This should be accompanied by fruits and vegetables rich in fiber, such as pears, strawberries, and sweet potatoes, while avoiding cheese, bananas, and white rice.

• The child can eat normally and return to his usual activities once he feels up to it, which usually happens within a few days after the inguinal hernia repair surgery.

• The child should take sponge baths in the following two days instead of using a bathtub or shower.

• The child should not climb, engage in sports, or lift heavy objects until the follow-up appointment with Dr. Wael Ghanem.

• The child should not ride a bike or use a riding toy until Prof. Dr. Wael Ghanem permits it.

• If the adhesive strips do not fall off on their own, the doctor will remove them at the follow-up visit after surgery.