Symptom

A bulge in one of the typical locations:

• just above or below the crease of the groin

• just above or below the navel

• at the navel

Home care

If you suspect a hernia, take the child to the doctor.

Precautions

-    A strangulated hernia is a medical emergency that must be immediately corrected surgically (within hours). Signs that a hernia has become strangulated are: swelling; severe pain; nausea; vomiting; severe weakness or collapse. If these symptoms appear, take your child to the hospital immediately. Never attempt home care for a strangulated hernia.

-    Trusses or belts used to reduce a hernia are useless and may be harmful or dangerous.

-    Doctors do not consider it beneficial to strap an umbilical hernia.

A hernia (or rupture) is a protrusion of tissue through the wall of the body cavity. It might be compared to the protrusion of an inner tube through a hole in an automobile tire. Several types of hernias may occur in children.

The most common hernia in a child is an indirect inguinal hernia, which is present at birth but may be or may not be recognized immediately. In fact, this type of hernia is not usually noticed until some later age. The hernia begins as a bulge just above the midpoint of the crease of the groin. It then enlarges toward the middle of the body until it reaches and enters the scrotum (the pouch containing the testes) of a boy or the labia majora (outer folds of the external genitals) of a girl. The bulge is actually a pouch-like sac underneath the skin made of peritoneum (the membrane that lines the abdominal cavity). The sac usually contains either a portion of the veil-like apron that overlies the intestines or a loop of the small intestine. Less often, it contains a loop of the large bowel, part of the urinary bladder, or an ovary.

A rarer hernia in children is a femoral hernia, which appears below the crease of the groin, near where the pulse of the main artery to the leg can be felt. Occasionally, a ventral hernia appears in the midline of the abdomen, above or below the navel. In infants, an umbilical hernia often appears at the umbilicus (the navel). This is not a true hernia, however, because it contains no sac. An umbilical hernia usually disappears on its own before the child reaches five years of age.

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