Inguinal hernia (peds)
Revision as of 03:43, 12 July 2016 by Neil.m.young (talk | contribs) (Text replacement - " w/ " to " with ")
Inguinal Hernia
Background
- 1-2% of children hve these
- 10% become incarcerated
- 70% of incarceration occurs ininfants (usu <6 mo)
- 10% become incarcerated
- M:F 6:1
- 21% of F with inguinal hernia contain an ovary!
Diagnosis
- parents usu report bulge in scrotum or groin that incr with crying
- lack of transillumination indicates incarcerated hernia vs hydrocele (usu no chng with crying)
- UTZ
Differential Diagnosis
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
Management
- 95% can be reduced with out surgery using gentle FIRM CONTINUOUS pressure, trendelenberg, & analgesics
- Surgery consult or f/u if can't reduce. Ensure no obstruction