Often present within 1st year of life.
Indirect - most hernias are indirect and extend through the internal and external rings. Often on the right hand side.
Signs & Symptoms
- Asymptomatic bulge in the groin or scrotum - above the testicle
- May resolve when calm and supine
- Analgesia needed before reduction
- Gentle traction on the scrotum to help align the hernia sac with the external ring.
- While keeping gentle traction, squeeze distal to proximal
- Apply pressure laterally with the index and thumb along each side of the hernia neck and inguinal canal.
- Imagine you are trying to stretch open the rings.
- Gently add more pressure distally and help reduce the hernia.
- This can take up to 40minutes
Incarceration or Strangulation
- Happens in 7 - 30%
- Severe pain, bilious emesis, blood in stool, signs of peritonitis, redness and oedema on affected side of scrotum
- Don't attempt to manually reduce