Inguinal hernia (peds): Difference between revisions

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==Inguinal Hernia==
{{Peds top}} [[inguinal hernia]]
==Background==
*1-2% of children have these
**10% become incarcerated
***70% of incarceration occurs in infants (usually <6 mo)
*Male:Female ration = 6:1
*21% of female inguinal hernias contain an ovary!


==Clinical Features==
*Parents usually report bulge in scrotum or groin that increases with crying
*Lack of transillumination indicates [[incarcerated hernia]] vs [[hydrocele]] (usually no change with crying)


* 1-2% of children hve these, 10% become incarcerated, 70% of incarceration occurs ininfants (usu <6 mo), M:F 6:1, 21% of F w/ inguinal hernia contain an ovary!
==Differential Diagnosis==
* S/S: parents usu report bulge in scrotum or groin that incr w/ crying, lack of transillumination indicates incarcerated hernia vs hydrocele (usu no chng w/ crying), must distinguish btwn hydrocele, torsion, inguinal lymph node, UTZ can help!
{{Pediatric abdominal pain DDX}}
* Rx: 95% can be reduced w/o surgery using gentle FIRM CONTINUOUS pressure, trendelenberg, & analgesics
* Surgery consult or f/u if can't reduce. Ensure no obstruction


{{Testicular DDX}}


==Evaluation==
*Clinical diagnosis
*[[Testicular ultrasound]] for confirmation


[[Category:Peds]]
==Management==
*95% can be reduced without surgery using gentle firm continuous pressure, Trendelenberg, & analgesics
*Surgery consult or follow up if cannot reduce. Ensure no obstruction.
 
==Disposition==
 
==See Also==
[[Abdominal pain (peds)]]
 
[[Category:Pediatrics]]
[[Category:GI]]

Latest revision as of 23:16, 28 November 2019

This page is for pediatric patients. For adult patients, see: inguinal hernia

Background

  • 1-2% of children have these
    • 10% become incarcerated
      • 70% of incarceration occurs in infants (usually <6 mo)
  • Male:Female ration = 6:1
  • 21% of female inguinal hernias contain an ovary!

Clinical Features

  • Parents usually report bulge in scrotum or groin that increases with crying
  • Lack of transillumination indicates incarcerated hernia vs hydrocele (usually no change with crying)

Differential Diagnosis

Pediatric Abdominal Pain

0–3 Months Old

3 mo–3 y old

3 y old–adolescence

Testicular Diagnoses

Evaluation

Management

  • 95% can be reduced without surgery using gentle firm continuous pressure, Trendelenberg, & analgesics
  • Surgery consult or follow up if cannot reduce. Ensure no obstruction.

Disposition

See Also

Abdominal pain (peds)

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