DR PAUL SINCLAIR PAEDIATRICIAN

MY BABY HAS BEEN DIAGNOSED WITH A HERNIA IN HIS GROIN AND HIS DOCTOR SAYS HE NEEDS AN OPERATION TO FIX IT. PLEASE CAN YOU TELL ME MORE ABOUT THIS AND WHY SOMETHING AS DRASTIC AS SURGERY IS REQUIRED?

Inguinal hernias (in the groin) occur commonly in boys in the first few months and years of life, and only occasionally in girls. It does occur throughout generations of a family and there is more chance of it developing in babies born very prematurely or in babies with respiratory problems that cause excessive coughing early in life.

To understand how these hernias happen, it’s important to understand the inguinal canal. This is a passage that connects the intestinal space with the scrotum. It is along this canal that the testes descend in the last few months of pregnancy, where they should arrive safely in the scrotum by the time a baby is born. But because this canal stays open for some time, it’s possible that a bit of intestine or fluid slides into the canal. Unfortunately, in some cases the intestine can become trapped and start to swell, leading to impairment to the blood flow into the gut.

If this occurs and is not remedied rapidly, the portion of gut can die and then faeces leaks into the area, causing infection and often septicaemia. This is why it’s essential to fix this kind of hernia surgically, and to do so as an emergency as soon as possible. As long is it’s done soon and there aren’t complications, the surgery is rather quick and simple – with most babies going home the same day or spending just one night in hospital. If, however, the bowel is compromised (which can occur relatively quickly and unexpectedly), the surgery and post-operative care becomes more complicated and involves a longer hospital stay.

A milder form of hernia happens when the scrotum fills with fluid from that which surrounds the gut. This is called a fluid hernia hydrocoele, and is not dangerous, but should be monitored. If it’s still there at one year of age, it can be repaired electively.

Any unusual swelling or lumps in a baby’s groin need to be checked out by your paed as soon as possible to avoid complications and allow early correction, for which surgery is the only option.

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