Evie Yeap1, Maurizio Pacilli2, Ramesh M Nataraja3. 1. (Hons), DipAnat, Surgical Resident, Department of Paediatric Surgery, Monash Children@s Hospital, Vic. 2. MBBS (Hons), MD (Res), FRCS (Paed Surg), Consultant Paediatric and Neonatal Surgeon, Department of Paediatric Surgery, Monash Children@s Hospital, Vic; Senior Research Fellow, Department of Paediatrics, School of Clinical Sciences at Monash Health, Medicine, Nursing and Health Sciences, Monash University, Vic. 3. MBBS, BSc (Hons), GCCS (Hons), FRCSEd (Paed Surg), FFSTEd, FRACS (Paeds), Consultant Paediatric and Neonatal Surgeon,@ Department of Paediatric Surgery, Monash Children@s Hospital, Vic; Senior Lecturer, Department of Paediatrics, School of Clinical Sciences at Monash Health, Medicine, Nursing and Health Sciences, Monash University, Vic.
Abstract
BACKGROUND: An inguinal hernia is one of the most common paediatric surgical presentations in a primary care setting. Hernias can present in multiple ways, ranging from an emergency such as a strangulated hernia to a less urgent reducible hernia. OBJECTIVE: The aim of this article is to aid in appropriate diagnosis and management of hernias in children. The article also provides useful tips for hernia reduction that are especially beneficial in the primary care setting and assist with the identification of hernias that require urgent referral. DISCUSSION: Recognising the signs of a hernia containing compromised contents is essential to prevent serious complications such as intestinal perforation, testicular atrophy and ovarian damage. Other common conditions such as hydrocoele and undescended testis are sometimes confused with an inguinal hernia. Young patients under the age of three months and patients with concern for compromised contents require urgent referral. Recent evidence regarding controversial issues in inguinal hernia repair such as the role of laparoscopy and the relevance of a contralateral patent internal inguinal ring will be discussed.
BACKGROUND: An inguinal hernia is one of the most common paediatric surgical presentations in a primary care setting. Hernias can present in multiple ways, ranging from an emergency such as a strangulated hernia to a less urgent reducible hernia. OBJECTIVE: The aim of this article is to aid in appropriate diagnosis and management of hernias in children. The article also provides useful tips for hernia reduction that are especially beneficial in the primary care setting and assist with the identification of hernias that require urgent referral. DISCUSSION: Recognising the signs of a hernia containing compromised contents is essential to prevent serious complications such as intestinal perforation, testicular atrophy and ovarian damage. Other common conditions such as hydrocoele and undescended testis are sometimes confused with an inguinal hernia. Young patients under the age of three months and patients with concern for compromised contents require urgent referral. Recent evidence regarding controversial issues in inguinal hernia repair such as the role of laparoscopy and the relevance of a contralateral patent internal inguinal ring will be discussed.