Inguinal hernias are a common disorder in children. They are commoner in males as the testis migrates from its location on the posterior abdominal wall, down through the inguinal canal. A patent processus vaginalis may persist and be the site of subsequent hernia development.
Children presenting in the first few months of life are at the highest risk of strangulation and the hernia should be repaired urgently.
An inguinal hernia in a child is pathological, with a significant risk of incarceration and so requires surgical correction following the six/two rule:
For paediatric hernias a herniotomy without implantation of mesh is sufficient. Most cases are performed as day cases, neonates and premature infants are kept in hospital overnight as there is a recognised increased risk of post operative apnoea.
NOTE: umbilical hernias resolve within 3 years and rarely require surgical correction