Hernia

What is a hernia?

A hernia is a bulge that occurs when an organ or tissue in the body protrudes through a weakness in the area that normally contains it. The most common place that a hernia occurs is in the belly.

The two most common types of hernias in children are:

1. Umbilical hernia: An umbilical hernia occurs when a part of the intestine sticks through the abdominal wall through the navel.

Umbilical hernia

2. Inguinal hernia: An inguinal hernia occurs when part of the intestine pushes through the abdominal wall in or around the groin. Inguinal hernias occur in up to five out of 100 babies.

Inguinal hernia

Signs and symptoms of hernia

Umbilical hernia

An umbilical hernia usually appears a few weeks after birth. It usually occurs after the umbilical cord has fallen off. In general, it goes away before two years of age without treatment.

Signs and symptoms may include:

• a soft swelling around the navel
• the swelling may appear later in the day
• the swelling gets bigger if your child coughs, cries, sneezes or stiffens their abdominal muscles

Inguinal hernia

Signs and symptoms may include:

• a soft swelling above the groin or in the scrotum
• the swelling may appear later in the day
• the swelling gets bigger if your child cries, coughs, sneezes or stiffens their abdominal muscles

Causes of hernia

Umbilical hernia

The navel has very little muscle beneath the skin. It is a weak area. When a baby cries or pushes out their belly, the pressure sometimes pushes part of an organ or tissue through the navel.

Inguinal hernia

Baby boys and premature babies are more likely to have this type of hernia. The inguinal canal is the passage through which the testes descend into the scrotum. Normally, this canal closes shortly after birth. If it does not close completely, it leaves a hole through which part of the intestine can pass into the groin or scrotum. This creates a bulge under the skin called an inguinal hernia.

What your child's health-care provider can do if your child has a hernia

Your child's health-care provider will examine the hernia. They will decide whether your child needs surgery.

Treatment

Umbilical hernia

Most children do not need surgery for an umbilical hernia. It is rare for an umbilical hernia to become strangulated. Surgery may be required if the hernia is very large or not going away. If surgery is needed, it is a minor operation. During surgery, the intestine is put back in place. The abdominal wall muscles are stitched up. The surgery is usually done after the age of three years. 

Inguinal hernia

All children with inguinal hernia need surgery because the hernia may become strangulated. Usually, the operation will be booked ahead of time. However, if the hernia is painful, your child may need emergency surgery.

During surgery, the small intestine, or other organ or tissue, is pushed back into place. The surgeon repairs the hole or space that is causing the hernia. The surgeon may check the other side of the groin for another hernia or weakness.

In general, your child can return home the day of the surgery, and they can be active in a few days. More information is available here: Hernia repair: Care for your child after the operation.

Complications

If a loop of intestine or another organ or tissue becomes trapped in its hole, its blood supply can become blocked. This is called a strangulated hernia. When this occurs, the area becomes discoloured, swollen and painful. Your child may vomit. If this happens, take your child to their health-care provider immediately, or go to the nearest Emergency Department.

When to seek medical assistance

Make an appointment with your child's regular health-care provider if you notice a soft bulge or suspect a hernia.

Take your child to the nearest Emergency Department if you suspect your child has a hernia and:

• the swelling is painful
• the hernia is large and hard
• your child is vomiting
• the hernia appears red or discoloured