Inguinal hernia (peds): Difference between revisions
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{{Peds top}} [[inguinal hernia]] | |||
==Background== | ==Background== | ||
*1-2% of children have these | *1-2% of children have these | ||
**10% become incarcerated | **10% become incarcerated | ||
***70% of incarceration occurs infants (usually <6 mo) | ***70% of incarceration occurs in infants (usually <6 mo) | ||
*Male:Female ration = 6:1 | *Male:Female ration = 6:1 | ||
*21% of | *21% of female inguinal hernias contain an ovary! | ||
==Clinical Features== | ==Clinical Features== | ||
| Line 15: | Line 16: | ||
{{Testicular DDX}} | {{Testicular DDX}} | ||
== | ==Evaluation== | ||
*Clinical diagnosis | *Clinical diagnosis | ||
* | *[[Testicular ultrasound]] for confirmation | ||
==Management== | ==Management== | ||
*95% can be reduced | *95% can be reduced without surgery using gentle firm continuous pressure, Trendelenberg, & analgesics | ||
*Surgery consult or follow up if cannot reduce. Ensure no obstruction | *Surgery consult or follow up if cannot reduce. Ensure no obstruction. | ||
==Disposition== | ==Disposition== | ||
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)
- 10% become incarcerated
- 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
- Emergent
- Nonemergent
3 mo–3 y old
- Emergent
- Nonemergent
3 y old–adolescence
- Emergent
- Nonemergent
Testicular Diagnoses
- Scrotal cellulitis
- Epididymitis
- Fournier gangrene
- Hematocele
- Hydrocele
- Indirect inguinal hernia
- Inguinal lymph node (Lymphadenitis)
- Orchitis
- Scrotal abscess
- Spermatocele
- Tinea cruris
- Testicular rupture
- Testicular torsion
- Testicular trauma
- Testicular tumor
- Torsion of testicular appendage
- Varicocele
- Pyocele
- Testicular malignancy
- Scrotal wall hematoma
Evaluation
- Clinical diagnosis
- Testicular ultrasound for confirmation
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.