II. 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
    1. However, girls can present with ovary Herniate (see below)
  3. Presentation in first year of life in 50+ of cases

III. Pathophysiology

  1. See Testes

IV. Types

  1. Indirect Inguinal Hernia accounts for most Hernias in children
    1. Children account for 5% of Inguinal Hernias
  2. Other Groin Hernias are rare in children
    1. Direct Inguinal Hernia
    2. Femoral Hernia

V. Signs

  1. Location
    1. Left Side: 30%
    2. Right Side: 60%
    3. Bilateral: 10%
  2. Characteristics
    1. See Inguinal Hernia
  3. Other Findings
    1. Communicating Hydrocele (always present)
    2. Ovary Herniate
      1. Small, almond-sized lesion in the inguinal region
      2. Requires urgent intervention

VII. 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

VIII. References

  1. Behrman (2000) Nelson Pediatrics, Saunders, p. 1185-8
  2. Fuloria (2002) Am Fam Physician 65(2):265-70 [PubMed]

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