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Inguinal Hernia in ChildrenAka: Congenital Inguinal Hernia

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  1. See Also
    1. Inguinal Hernia
  2. Epidemiology
    1. Incidence
      1. Infants Overall: 0.5 to 1% of live births
      2. Premature Infants: 5 to 10%
    2. More common in boys by ratio of 4:1
    3. Presentation in first year of life in 50+ of cases
  3. Pathophysiology
    1. See Testes
  4. Types
    1. Indirect Inguinal Hernia accounts for most hernias
    2. Other Groin Hernias are rare in children
      1. Direct Inguinal Hernia
      2. Femoral Hernia
  5. Signs
    1. Location
      1. Left Side: 60%
      2. Right Side: 30%
      3. Bilateral: 10%
    2. Characteristics
      1. See Inguinal Hernia
    3. Other Findings
      1. Communicating Hydrocele (always present)
  6. Complications
    1. Incarcerated Hernia
    2. Strangulated Hernia
  7. Management: Surgical repair within first year of life
    1. Surgery should be scheduled soon after diagnosis
    2. Delaying surgery risks complications as listed above
    3. Bilateral repair often indicated even if unilateral
    4. Surgery can usually be performed outpatient
  8. References
    1. Behrman (2000) Nelson Pediatrics, Saunders, p. 1185-8
    2. Fuloria (2002) Am Fam Physician 65(2):265

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