How to handle your child’s inguinal hernia

I had first noticed the bulge in my five-year-old son, Cash’s abdomen as I was drying him following his shower. With the water glistening off his freshly cleaned skin I could see the outline of an unusual lump between his pelvis and upper thigh. It was odd. There was no redness or discolouring: just a mass with no visible evidence of its origin. Immediately a sense of concern washed over me. Cash had been experiencing bouts of intermittent pain in this area for a number of weeks with the cause unfounded. The pain would come and go and my wife and I had not noticed any previous signs of swelling.

I laid my son on his bed to have a closer look. As he rested on his back the bulge became more pronounced. Still concerned, I made an appointment with our family physician the next day.

Strangely, by the time our doctor examined my son the lump on his groin had disappeared. An ultrasound was requested and confirmed that the root of the swelling and pain my son was experiencing was caused by an inguinal hernia.

I was shocked by the diagnosis. How could Cash have a hernia?

I soon came to find out that inguinal hernias are not uncommon in children. According to McMaster Children’s Hospital Pediatric Surgery Clinic, “Inguinal hernias occur in up to five out of 100 babies.”

The story of the inguinal hernia begins during a baby’s development, explains the Hamilton, Ont. clinic. “There is a natural opening between the abdominal cavity and the scrotum or groin. It is called the inguinal canal. In boys, the testicles develop in the abdomen and move down into the scrotum through the inguinal canal.”

Does this mean girls are off the hook? Not exactly. Although girls don’t have testicles, they do have an inguinal canals and can get hernias, too.

If the lining isn’t completely closed, what should stay safely behind the abdomen can pass through and enter the groin fluid, intestines or other tissues. This could lead to complications.

Sometimes the bowel can become trapped in a hernia, according to literature from McMaster. This may cause the bowel to become blocked. If the blood flow to the area also becomes blocked, the bowel and testicle (in boys) may be damaged.

Because of potential complications, inguinal hernias require surgery to be repaired which involves an incision in the groin area. This was a fact that my family had to face with our son and the treatment option came as swiftly as his diagnosis. There was no avoiding it.

Cash’s hernia repair was a success and he was back to himself within a week. Inguinal hernias are not uncommon, but if your child experiences one it will be uncommon to you. During the process, I learned that the more questions I asked of medical staff and other parents the more at ease I was about my son’s diagnosis and treatment.

When it comes to any medical procedure or surgery, parents should familiarize themselves with their child’s medical team and understand the steps to recovery, keeping in mind that no question is a silly question.

What to expect during hernia surgery:

• Inguinal hernia surgery is done under a general anesthetic. Your child will be asleep and will not feel any pain. Younger children can receive flavoured sleep medication from an anesthesiologist through a mask.
• Depending on the hospital, one parent will be allowed to accompany their child into the operating room only until he is asleep.
• Inguinal hernia repair involves the surgeon making a small incision near the hernia. Any tissue outside of the abdomen is replaced. The weak spot is then closed and reinforced with dissolvable stitches.
• This surgery takes between 30 minutes to 1 hour.

What to expect after hernia surgery:

• Your child will be moved to a recovery room post-surgery where he will be monitored by medical staff until awake. A nurse will bring you to be with your child as soon as possible. You and your child will remain in recovery until he is alert and stable.
• Children coming out of anesthesia react in different ways. Your child may feel groggy, dizzy or nauseous. Clear fluids should be given until he can drink them without throwing up. Slowly introduce solid foods.
• Inguinal hernia repair is usually outpatient surgery. When it is safe for your child to go home you will review at-home care with your nurse or doctor.
• Your child will be restricted from bathing for a few days post surgery.
• Recovery time depends on the child. Your surgeon will determine when he can resume normal activity.

Originally published in ParentsCanada magazine, Fall 2017.