Introduction

No disease of the human body, belonging to the province of the surgeon, requires in its treatment, a better combination of accurate, anatomical knowledge with surgical skill than Hernia in all its varieties.

Sir Astley Paston Cooper [1]

I know more than a hundred surgeons whom I would cheerfully allow to remove my gallbladder but only one to whom I should like to expose my inguinal canal.

Sir Henage Ogilvie [2]

Inguinal hernias are a large portion of most pediatric surgeons practice and may often be greater than 10% of their case load. Hernias can be quite straight forward or quickly turn into a several hour endeavor. An incarcerated neonatal hernia with an undescended testicle may be one of the more difficult challenges in pediatric surgery. Because they are so common it is important to have a systematic approach to inguinal hernias both in the clinic and operating room.

Approximately four hundred years ago the French surgeon Ambroise Pare described the reduction of an incarcerated pediatric hernia and the application of trusses. He recognized that inguinal hernias in children were probably congenital in nature and that they could be cured [3]. Despite the many historical descriptions of conservative medical management of inguinal hernias no effective nonsurgical means of treating this condition is recognized. All pediatric inguinal hernias require operative treatment to prevent the development of complications such as incarceration or strangulation.

Inguinal hernia repair remains one of the most common pediatric operations performed. Most hernias that are present at birth and in childhood are indirect inguinal hernias. It is important to remember that hernias can be organ- or life threatening if not expeditiously managed.

Content in this module is referenced in SCOREInguinal Hernia overview

see also Acute Scrotum