Inguinal Hernia in Infants and Children.
What is an inguinal hernia?
The story of the inguinal hernia begins during a baby's development. When a baby boy is growing in the
womb, the testicles first grow in his belly. As the fetus develops, their testicles travel down a tunnel into
the scrotum. (This tunnel also exists in baby girls.) Occasionally, the tunnel (called the processus
vaginalis) does not close. This leaves an opening from the belly into the inguinal canal, where a piece of
bowel or an ovary can become trapped. When this happens, what should stay safely in the abdomen—
fluid, intestines, other tissues—can pass through and enter the groin. To avoid potential complications,
inguinal hernias require surgery to repair.
Inguinal hernias may occur on one or both sides of the body and are much more common in men than
women. An inguinal hernia can appear at any age. Infants may be born with one that doesn’t show up
until they become adults. About five out of every 100 children are born with the condition. An inguinal
hernia can also develop over time if you increase pressure on the walls of your abdominal muscles
through activities like straining to go to the bathroom, coughing over a long period, being overweight, or
lifting heavy weights. If you have a family history of inguinal hernia, you may be at a higher risk for one.
Infants born before their due date are also at higher risk.
About 3% to 5% of healthy, full-term babies are born with an inguinal hernia. In premature infants, the
incidence is substantially increased―up to 30%. If an inguinal hernia is not treated, it can cause serious
problems.
There are two types of inguinal hernias:
Indirect inguinal hernias: Indirect inguinal hernias are the most common type of inguinal hernia
in children and are present at birth. During fetal development, all babies have a canal (called the
inguinal canal) that goes from their abdomen to their genitals. In boys, this canal allows the
testicles (which develop in the abdomen) to travel to the scrotum. In both boys and girls, the
canal is supposed to close off prior to birth. An indirect hernia occurs when the inguinal canal
fails to completely close during fetal development, leaving an opening for abdominal contents to
protrude through the defect.
Direct inguinal hernias: Direct inguinal hernias are very rare in children. This type of hernia is
caused by a weakness in the abdominal wall that allows intestines to protrude through. These
hernias are more frequent in males.
What is Indirect Inguinal Hernias
Indirect inguinal hernias are often present at birth. They are more common in babies with testicles.
These hernias occur when one or both of the inguinal canals do not close during fetal development. This
failure to fully close can result in organs in the abdomen being pushed outward. Certain genes may
increase the risk of developing inguinal hernias. While most indirect inguinal hernias are congenital, they
don’t always show up in infancy or even childhood. Therefore, an adult may be diagnosed with an
indirect inguinal hernia that wasn’t present at birth but appears later in life. This might occur due to an
acquired weakness of the inguinal ring.
What causes indirect hernias in babies?
Indirect inguinal hernias in babies are congenital. This means that during fetal development, something
did not develop completely. In this case, the inguinal canal, which runs on either side of the abdomen to
the groin, did not close. When that happens, part of the internal abdominal organs pushes through that
canal, causing a bulge in the groin area
