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Home Books CURRENT Procedures: Surgery

Chapter 48. Pediatric Inguinal Hernia

Kimberly McCrudden Erickson, MD

  • Presence of a hernia (elective).
  • Incarceration or strangulation (emergent).

Absolute

  • Coagulopathy.
  • Thrombocytopenia.

Relative

  • Extreme prematurity.
  • Cardiopulmonary comorbidities.
  • Immunosuppression.

  • The patient should be supine on the operating table.
  • Following induction of general anesthesia, the patient may be turned on his or her side for placement of a caudal block if appropriate.

  • Analgesia using acetaminophen, ibuprofen, and narcotics as needed.
  • Heavy lifting and high-contact sports in older children and adolescents should be limited for 4–6 weeks postoperatively.

Acute

  • Bleeding.
  • Wound infection.
  • Injury to spermatic vessels.
  • Injury to vas deferens.
  • Postoperative hydrocele.
  • Damage or entrapment of ilioinguinal nerve.

Chronic

  • Testicular atrophy.
  • Recurrence.
  • Iatrogenic undescended testicle.

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