Inguinal Hernia in Children

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An inguinal hernia occurs when part of your child’s intestine pushes through a weak spot in their lower abdomen or groin area. The hernia creates a soft lump that is felt through the skin and that may change in size. In boys, the hernia may appear in the scrotum. Inguinal hernias happen at any age, but they primarily occur in infancy and childhood.

There are two types of inguinal hernias:

  • Indirect inguinal hernias are the most common type.
  • Direct inguinal hernias occur mainly in adult males.

Causes & Symptoms of Inguinal Hernias

The type of inguinal hernia that develops depends on the cause:

  • Indirect inguinal hernias form when an opening in your child’s abdominal wall that is present as a fetus does not close normally, resulting in a weak spot in the abdominal wall that allows the intestines to push through.
  • Direct inguinal hernias form when stress to the abdominal wall weakens the abdominal muscles, allowing the intestine to bulge out.

Boys are more likely to develop these hernias because of the way the abdomen, groin and genitals develop in the womb. Your child may be more likely to develop an inguinal hernia if they:

  • Are male
  • Are obese
  • Have a family history of inguinal hernias
  • Often strain to have a bowel movement
  • Have a chronic cough

The symptoms of inguinal hernia vary in each child. Some inguinal hernias are painful while others aren’t. Other symptoms may include:

  • A lump in the groin or scrotum area
  • Pain or pressure in the groin area that gets worse with coughing, strain or activity
  • Steady or increasing pain in the lump

In many cases, the swelling is more obvious or only appears when the child is crying or straining. Inguinal hernias in children may also get stuck in place, which is called incarceration. Incarceration is common with inguinal hernias; if this is happening with your child’s hernia, please contact your child’s healthcare provider immediately.

In some cases, the blood supply to the piece of intestine that is bulging through the abdominal wall gets blocked. This is called a strangulated hernia. In severe cases, the intestine becomes partly or fully blocked. Symptoms in severe cases may include:

  • Nausea
  • Vomiting
  • Lack of hunger
  • Infection

Diagnosis & Treatment at UVA Health Children's

An inguinal hernia does not heal on its own, but massaging and applying pressure to the lump can reduce its size and help return the intestines into the abdomen.

Your child’s healthcare provider will attempt to push the intestines back into your child’s abdomen while examining your child. Your child may also need imaging exams, such as:

  • Ultrasound
  • X-ray
  • CT scanning
  • MRI scanning

Surgery can repair an inguinal hernia. The surgery may be either:

  • Open (called a herniorrhaphy; in this procedure, the surgeon opens up the abdomen wall to repair the hernia and the weak spot in the abdomen wall)
  • Laparoscopic (very small instruments and a video camera are introduced into the abdomen through small cuts to repair the hernia and weakened abdominal wall)