Health Topics for Child Health and Development

UI Children's Hospital

UI Family Care Centers

Divisions Within the Department of Pediatrics

Iowa Registry for Congenital and Inherited Disorders

Hernias: pediatric

A hernia occurs when an internal part of the body bulges out through weakened muscles that normally contain it. This weakness in the muscular wall was either present at birth or developed later as a result of injury, internal pressure, or a tumor.

While a hernia can happen in various parts of the abdominal area, its most common locations are the groin and belly button. This is true for children and adults.

In children, the two most common types of hernia are:

• the inguinal hernia (found in the groin) and
• the umbilical hernia (found in the belly button area)

Two other types of hernias found sometimes in children are:

• a ventral hernia (which develops at the site of a previous surgery) and
• a femoral hernia (which appears very low in the groin area, just above the thigh)

An inguinal hernia is the protrusion of a portion of the intestine into the peritoneal sac that should normally shrink at birth. It is the most common condition requiring surgery in young children. About 50 percent of inguinal hernias are discovered within the first year of life and most are seen in boys. An inguinal hernia appears as a bulge in the groin area that may extend into the scrotum or labia. The bulge may only be visible with crying or straining. Local swelling and discomfort may be noticeable. An inguinal hernia will not resolve on its own and does require surgery.

A serious risk with inguinal hernia occurs when a loop of bowel becomes trapped (incarcerated) or if the blood supply to that part of the bowel becomes impaired (strangulation). Strangulation may be a life-threatening complication if not treated. Cramping, abdominal pain, and vomiting associated with an inguinal hernia should be reported to your healthcare provider immediately.

In an umbilical hernia, a portion of the intestine protrudes through the abdominal wall at the umbilicus (or belly button area). This happens because of failure of the opening of the belly button or umbilicus to close before birth. An umbilical hernia appears as a bulge near or at the belly button and is diagnosed by a healthcare provider during a physical examination. In most cases, there may be no other symptoms and the hernia often naturally disappears by the age of 5 years.

A hernia should slip back into place and go flat with a gentle push or when the patient lies down. However, an umbilical hernia re- appears when pressure is removed or when the child gets up. Do not worry about this unless pain develops or the bulge is suddenly much larger than it had been. Treatment of an umbilical hernia is usually unnecessary. However, it is important to watch the hernia to make sure no complications develop. If an umbilical hernia is still present by age 5 to 7, surgery to repair the hernia may be recommended.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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