Hernias are a common medical condition that can affect individuals of all ages, including children. Pediatric hernia is a common condition where a child's tissue pushes through a weak spot in their muscles. In India, the prevalence of hernias in children varies depending on the type and region. For example, inguinal hernias in children range from 0.8% to 5% in full-term babies. In pre-term and low-birth-weight babies, it can be as high as 20-30%.

In this blog, we will be discussing the signs, symptoms, and treatment options for hernias in children, which are essential for parents and caregivers to understand. Early diagnosis and proper child hernia treatment are important to help children recover quickly and avoid future problems. So, let’s start with a fresh understanding of what a hernia is.

What is a Hernia?

A hernia occurs when an organ or tissue pushes through a weak spot or opening in the muscle or tissue that holds it in place. Inguinal and umbilical hernias are the most common types found in children.

• Inguinal Hernia: This type of hernia occurs in the groin when a portion of the intestine or fat bulges through a weak spot in the abdominal wall. It is more often seen in boys than in girls.
• Umbilical Hernia: This type of hernia occurs when a section of the intestine or fatty tissue pushes through the abdominal wall near the belly button. This type of hernia is very common in newborns and infants.

Signs and Symptoms

Recognising the signs and symptoms of hernias in children is crucial for timely intervention. Common signs and symptoms include:

• Visible Bulge: A noticeable bulge or swelling in the groin or near the belly button. This bulge may become more apparent when the child is crying, coughing, or straining.
• Pain or Discomfort: Children with hernias may experience pain or discomfort in the affected area, especially when engaging in physical activities or straining.
• Tenderness: The bulge may be tender to the touch, and the child may react with discomfort when the area is pressed.
• Vomiting: In severe cases, a hernia can cause nausea and vomiting, particularly if the hernia becomes strangulated (when the blood supply to the protruding tissue is cut off).

Diagnosis

If you suspect your child has a hernia, it is essential to seek medical attention promptly. A healthcare provider will typically perform a physical examination to diagnose the condition. In some cases, imaging studies such as ultrasound or X-rays may be required to confirm the diagnosis and assess the severity of the hernia.

Treatment Options

The treatment for hernias in children depends on the type and severity of the hernia. Common treatment options include:

Watchful Waiting: For small umbilical hernias, especially in infants, doctors might recommend a "watchful waiting" approach. This means keeping an eye on the hernia without immediate surgery. Here's what this involves:

• Regular Check-Ups: The child's doctor will check the hernia regularly to ensure it's not causing problems. Parents will be taught what signs to look for at home, such as increased swelling or pain.
• Guidance for Parents: Parents will get tips on how to support their child during this time, like avoiding activities that could strain the belly muscles and make the hernia worse.
• Follow-Up Appointments: Regular visits to the doctor are crucial to see if the hernia is getting better on its own or if a different treatment is needed.

Surgical Repair: Surgery is often needed for inguinal hernias and larger umbilical hernias that don't get better on their own. Surgery helps prevent problems like the hernia getting stuck or cutting off the blood supply. 

The surgical process typically includes:

• Pre-Surgery Check: Before surgery, the child will have a health check to ensure they are fit for the procedure. This might include blood tests and other exams.
• Anaesthesia: The child will be given medicine to make them sleep and not feel pain during the surgery.

The Surgery

• Inguinal Hernias: These hernias do not heal on their own and must be repaired surgically to prevent intestinal strangulation or incarceration. The surgery called a herniorrhaphy, is recommended for all pediatric patients with inguinal hernias. During the surgery, the doctor makes a small cut in the groin, pushes the hernia contents back into the abdomen, and then stitches the opening shut. Inguinal hernias can be repaired through an open herniorrhaphy (an incision in the groin) or using a minimally invasive approach (laparoscopic herniorrhaphy).
• PIRS (Percutaneous Internal Ring Suturing) is a minimally invasive technique for repairing inguinal hernias by suturing the internal ring, often resulting in less scarring and quicker recovery; a study shows it is better than open repair for children as it allows checking both sides in one session and results in smaller scars.
• Umbilical Hernias: The surgeon makes a small cut near the belly button, pushes the bulging tissue back into place, and fixes the weak spot in the muscle.

After Surgery Care: After the surgery, the child will be watched until they wake up from the anesthesia. Parents will get instructions on how to care for the child at home, including how to manage any pain and care for the cut area. Most children can go back to their usual activities within a few days to a week, but should avoid heavy activity for a while.

Follow-Up Appointments: Follow-up visits with the doctor are important to make sure the child is healing well and to address any concerns. Surgery for hernias in children is generally safe and successful, allowing them to return to their normal activities and enjoy a healthy life.

Conclusion

Hernias in children is a common condition that can cause discomfort and concern for parents. Understanding the signs, symptoms, and treatment options is essential for ensuring prompt and effective care. If you suspect your child has a hernia, consult a healthcare provider for an accurate diagnosis and appropriate management. Early intervention can prevent complications and help your child lead a healthy and active life.

For parents seeking hernia treatment in Delhi, there are many qualified healthcare providers available. Hernia surgery in Delhi is generally safe and successful, providing children with the opportunity to return to their normal activities and enjoy a healthy life. You can check out MASSH for more information about hernia treatment for children. We offer specialised minimally invasive surgical treatment options that are low-risk and have quick recovery option for your children. Request a call back on our website today and consult with our specialists to learn more about hernia treatment and preventative measures.