[Sportschosun reporter Jang Jong-ho] Parents may notice that one side of a child’s groin is bulging while bathing the child or changing a diaper. If the bulge appears only when the child cries or strains and disappears once the child relaxes, it is easy to dismiss it as insignificant. However, this may be a typical symptom of a pediatric inguinal hernia and requires attention.
A hernia is a condition in which part of the intestine or tissue within the abdominal cavity protrudes through a gap in the abdominal wall or a passage that has not closed. Most hernias in children occur in the groin and are inguinal hernias. They often develop when a passage formed during fetal development fails to close completely after birth.
During fetal development, a passage forms between the abdomen and the groin. In boys, the testicles pass through this passage as they descend from the abdomen into the scrotum. Normally, the passage closes around the time of birth. In some cases, however, it remains partially open, allowing the intestine or other abdominal tissue to protrude and cause a hernia. The condition is more common in boys than in girls, and the risk is higher in premature infants, particularly those born at an earlier gestational age.
The most common symptom of a pediatric inguinal hernia is a bulge in the groin. The bulge may not be noticeable at rest but can appear when a child cries, coughs or strains, and may disappear when the child relaxes. Because the symptoms often come and go, caregivers may fail to recognize the condition or may not take it seriously.
However, the disappearance of the bulge does not mean that the hernia itself has gone away. If the protruding intestine or tissue becomes trapped and cannot return to its original position, the condition can become an emergency. Incarceration should be suspected if the bulging area suddenly becomes hard, swollen and red, does not go back in, or if the child becomes extremely irritable or develops vomiting, abdominal pain or refuses to feed. If incarceration persists, blood flow to the intestine can be blocked, leading to intestinal damage or necrosis. Prompt medical evaluation and treatment are therefore necessary.
Pediatric inguinal hernias are treated with surgery. The surgical approach is determined based on the child’s age and health, as well as the hernia’s location and whether it affects one or both sides. Laparoscopic surgery, which involves minimal scarring and a faster recovery, is increasingly performed. Because the surgeon inserts a camera and instruments through small openings, the procedure leaves almost no scars and allows for a quicker recovery. It also enables the opposite groin to be examined during surgery, supporting accurate diagnosis of bilateral hernias and more precise treatment.
Early detection is important in cases of pediatric hernia. When changing a diaper or bathing a child, caregivers should check whether both sides of the groin and scrotum appear symmetrical. It is also helpful to observe whether one side of the groin repeatedly bulges when the child cries or strains. If the groin repeatedly protrudes or a lump can be felt, the child should be examined by a specialist.
Professor Boo Yoon-jung of the Department of Pediatric Surgery at Korea University Anam Hospital said, "Pediatric hernia is a condition in which caregivers can relatively easily detect abnormal signs in everyday life." She advised, "When changing a diaper or bathing a child, check whether both sides of the groin look symmetrical. If one side is repeatedly observed to bulge, it can also be helpful to take photos or videos and show them to medical staff during the examination."
Professor Boo Yoon-jung was the first in South Korea to introduce and perform laparoscopic surgery for pediatric hernias. Since then, laparoscopic minimally invasive surgery for pediatric hernias has become widely available nationwide and established itself as a primary surgical treatment. As techniques such as robotic surgery continue to advance, more precise minimally invasive procedures tailored to the anatomical characteristics of pediatric patients are expected to become possible.
Jang Jong-ho, reporter bellho@sportschosun.com
This article has been translated by GripLabs Mingo AI.
