| A hernia occurs when a tissue or body part moves out of the body cavity in which in normally lies. Umbilical hernias are the most common and usually do not need to be repaired unless they are very large or do not go away by the time your child is four years old.
Inguinal hernias are also common and cause a bulge in the groin area or scrotum. Repair of inguinal hernias are the most common surgical procedures in children. This type of hernia always needs to be repaired and will not correct on its own.
Inguinal hernias occur in about 1-2% of male infants and 0.5% of female infants and are even more common in premature babies (about 30%). They are more common on the right side (60%), but can also occur on the left side (30%) or on both sides (10%). About 50% of inguinal hernias are diagnosed in an infants first year of life, usually before they are six months old.
Because there is a risk of a hernia becoming strangulated (see below), surgical repair of inguinal hernias is usually performed shortly after diagnosis. It is usually an outpatient procedure, especially in older infants and in those without other medical problems.
Although controversial, when a one-sided hernia is repaired, the surgeon may explore the other side to make sure there isn't a hernia there too, because there is about a 30-50% chance of developing a hernia on the other side if it isn't also repaired.
The timing of surgery and whether or not the other side should be explored and repaired if necessary are things that you should discuss with your Pediatric surgeon.
Other types of hernias include femoral hernias, which are less common in infants, and incisional hernias, which occur at a site of a previous surgery.
Most hernias are reducible, meaning that you can gently push them back to their normal body site. An irreducible hernia can't be returned to its normal body cavity and can become swollen and fixed in place (incarcerated hernia) and then painful and cut off from circulation (strangulated hernia). Irreducible hernias that become painful are medical emergencies and should be immediately evaluated by your physician or in the emergency room for further treatment.
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