A hernia means the opening and bulging of part of the abdominal contents (usually the intestines) through the abdominal wall.
A hernia may occur in any part of the abdominal wall, but it usually appears in the groin area. It is more common in boys and is seen more often in premature and low-birth-weight babies. It may not be noticeable at birth, but at 2 to 3 months of age or later, because of the baby's crying and the increased pressure inside the abdomen, the abdominal contents are pushed into the scrotum or the groin area.
Symptoms: in older children, severe and persistent coughing and standing for long periods make the hernia visible, and it disappears when the child lies down. When touched, the groin area feels raised. If a complication occurs, other symptoms such as loss of appetite, pain, restlessness and constipation are added.
Care before surgery: keep the child calm before surgery; the child should have nothing to eat or drink for at least 8 hours before surgery; tell the staff about any history of heart disease or hereditary disease and any medicines the child takes.
- If the child takes aspirin, it should be stopped 7 to 10 days before surgery.
Care after surgery: keep the child calm after surgery; the child should have nothing to eat or drink until the treating doctor says so. If the child has pain, nausea or vomiting, tell the nurse. Care after discharge: the child can have a bath 48 to 72 hours after the operation.
Keep the operation site dry and clean (in babies who do not have bladder and bowel control, the nappy should not cover the operation site and should be changed as soon as it is wet, to reduce the chance of irritation and infection). Depending on the treating doctor's opinion, do not use a bath or tub for 24–72 hours. After 72 hours no dressing is needed.
There are no food restrictions. If there is pain, a painkiller (acetaminophen/paracetamol) can be used. Stitches are usually removed 8–10 days after the operation. Sports activities are allowed 2 to 3 months after surgery. Babies do not need to have their movement restricted, but older children should avoid activities such as lifting, pushing, cycling, etc. for three weeks. Walking is allowed after discharge, but try not to put pressure on the operation site when getting up and sitting down.
Complications of an untreated hernia: whenever a lump appears in the groin, the patient should see a doctor. If left untreated, the hernia gets worse and the patient is at risk of bowel obstruction, which can lead to emergency surgery.
Surgery strengthens the weakened layers of the abdominal wall and resolves the patient's problem. Using a hernia truss is not recommended under any circumstances, because it makes surgery more difficult and increases the chance of the hernia coming back after surgery.
Prepared and compiled by: Azam Tirafkan – Education Unit
Document code: NO-BR-44