Chapter 48. Pediatric Inguinal Hernia

• 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.