Inguinal hernia in childhood

Inguinal hernia in the pediatric age group is the reason for the greatest number of programmed and elective surgeries. This health problem affects 1-7% of the pediatric population; it predominates in males and can be unilateral or bilateral, although it is more frequent on the right side. It can be diagnosed at birth or later, at any age.

Also known as inguino-scrotal hernia, it is congenital in infancy: when the peritoneo-vaginal duct —the structure that connects the abdomen with the inguinal region and which normally should close at birth— does not close properly, the abdominal viscera and structures pass into the inguinal or scrotal region, thus forming the hernia. It is characterized by a non-painful increase in volume in this region, which increases with coughing, physical exertion and crying; it is less evident and even disappears when the patient is lying down.

On physical examination of the inguinal or inguinoscrotal region, a rounded protrusion with a smooth, non-painful surface, which is not radiolucent in the presence of light, is evident. When the hernia reaches a large size, it is possible to auscultate hydroaerial sounds and, in the absence of complications, it can be easily reduced manually into the abdominal cavity through the deep inguinal ring.

The fact that inguinal hernia is the most frequent surgery encountered by the pediatric surgeon during his routine practice highlights the importance of knowing the proper management of this condition to ensure a favorable evolution, without added complications.