Inguinal hernia is common in children, presenting as an intermittent groin swelling. It is much more common in boys but approximately 10% occur in girls. In children, inguinal hernia is due to persistence of a widely patent processus vaginalis and it is very unusual for there to be associated muscular or fascial weakness. Surgery is therefore normally a simple herniotomy.
Although this is the same underlying pathology as a hydrocele, hernias do not resolve in the same way and so a child in whom an inguinal hernia is suspected should be referred at initial diagnosis.
An inguinal hernia can become irreducible or incarcerated. The age group most a risk would be infants below 3 months of age. For this reason we would suggest that a suspected inguinal hernia in this age group is referred urgently.
FM, LS, JB Sept 22
Who to refer:
- Any child with a suspected inguinal hernia
- An infant under 3 months of age should be referred urgently
- Any child with an irreducible hernia should be referred as an emergency
How to refer:
- Refer via SCI gateway for an out patient or via RHCYP switchboard for an emergency
Referral priority
- An infant under 3 months of age will be triaged as urgent.
- Older children will be triaged as routine.
- An irreducible hernia should be referred as an emergency.
Surgical priority
- Herniotomy in an infant under 3 months is an urgent procedure.
- Herniotomy in older children is a routine procedure.
