Overview
What is the pathophysiology of pediatric hernias?
What is the prevalence of pediatric hernias in the US?
What is the global prevalence of pediatric hernias?
What is the mortality and morbidity associated with pediatric hernias?
What are the racial predilections of pediatric hernias?
What are the sexual predilections of pediatric hernias?
Which age groups have the highest prevalence of pediatric hernias?
Presentation
Which clinical history findings are characteristic of pediatric hernias?
Which physical findings are characteristic of pediatric hernias?
What causes pediatric hernias?
Which conditions increase the risk of inguinal hernia?
DDX
What are the differential diagnoses for Pediatric Hernias?
Workup
What is the role of lab tests in the workup of pediatric hernias?
What is the role of imaging studies in the workup of pediatric hernias?
What is the role of laparoscopy in the workup of pediatric hernias?
Which histologic findings are characteristic of pediatric hernias?
Treatment
How are pediatric hernias treated?
What is the role of surgery in the treatment of pediatric hernias?
How is an open repair of pediatric inguinal hernia performed?
What is a neglected inguinal hernia?
How is inguinal hernia surgery performed in girls?
What is the surgical intervention for inguinal hernia with testicular or vas anomalies?
How is diagnostic laparoscopy performed for pediatric hernias?
How are incarcerated hernias treated?
What is manual reduction of incarcerated hernia performed?
How is hernia strangulation treated?
How is an umbilical hernia treated?
What is the role of laparoscopic needle-assisted repair in the treatment of inguinal hernia?
Which specialist consultations are beneficial to patients with pediatric hernias?
Which dietary modifications are used in the treatment of pediatric hernias?
Which activity modifications are used in the treatment of pediatric hernias?
Medications
What is the role of medications in the treatment of pediatric hernias?
Follow-up
What is included in long-term monitoring of pediatric hernias?
When is inpatient care indicated in the treatment of pediatric hernias?
Which medications are used for pain management of pediatric hernias?
When is patient transfer indicated for the treatment of pediatric hernias?
What are the possible complications of pediatric hernias?
What is the prognosis of pediatric hernias?
What is included in patient education about pediatric hernias?
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Typical appearance of an infant with a large right indirect inguinal hernia. The right scrotal sac is enlarged and contains palpable loops of bowel and fluid.
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A premature baby boy with bilateral giant inguinoscrotal hernias. Because of the large size of the hernias, operative repair typically requires repair of the inguinal floor in addition to the high ligation of the indirect hernia sac.
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Illustration of the technique for intraoperative diagnostic laparoscopy to evaluate for the presence of an asymptomatic contralateral inguinal hernia at the time of elective repair of an indirect inguinal hernia.
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Laparoscopic view of a left indirect inguinal hernia at the time of surgery for laparoscopic needle-assisted repair.
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Laparoscopic needle-assisted repair of a left indirect inguinal hernia. Note the passage of a Prolene suture through a small 22G spinal needle; this is used for creation of the purse-string suture that closes the open inguinal ring.
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Laparoscopic view of the repaired left indirect inguinal hernia with the closed Prolene purse-string suture around the internal inguinal ring.