Groin hernia often looks like a rounded bulge at the groin or at the scrotum. Both children and adults can have groin rupture without feeling it, but it can also cause major problems. Groin hernia does not disappear by itself but must be operated on. Groin hernias in children are always operated. In adults, it is operated if it causes problems.
What is groin hernia?
The abdominal wall is a name for the tissue that exists between the skin and the organs of the stomach. It consists of several layers. At the bottom is a peritoneum. Then there is a fat layer, one or more muscle layers and a layer of subcutaneous fat.
In the case of hernia, the peritoneum and abdominal contents are squeezed out by a weakening of the abdominal wall. The abdominal contents usually consist of fat and part of the intestine.
A sack with abdominal contents is formed under the skin, a so-called hernia sac. The contents of the hernia sac can travel in and out through the opening in the abdominal wall.
One of the most common places on the body where hernia can occur is in the groin. By groin hernia is also meant hernia that sits down towards the thigh, so-called thigh hernia.
Groin hernia can occur in both right and left groin. You can also get groin hernia on both sides at the same time.
Squeezed groin hernia
Squeezed groin fracture is when the contents of the hernia sac are squeezed during weakening and cannot be pushed back through the abdominal wall. This may, for example, be due to swelling during the weakening.
The swelling can squeeze both the contents of the hernia sac and its blood vessels. It can cause blood circulation to stop and the contents of the hernia sac to die. It is a serious condition.
Other forms of hernia
The hernia can also penetrate into the scrotum. It is called a hernia. The hernia sack can be filled with only liquid, it is called a hernia. An umbilical hernia is when the hernia sac is squeezed out by a weakening in the vicinity of the navel.
Symptoms of groin hernia
Both adults and children can have groin rupture without feeling it. It may be discovered in connection with another investigation. But groin hernia can also cause major problems.
The noise often hurts in the beginning when it is small and pushes forward.
The symptoms of groin hernia below apply to both children and adults.
inguinal
Groin hernia can cause one or more of the following symptoms:
- You see or feel a soft bulge under the skin at the groin or scrotum. It is possible to push the bulge back into the abdomen.
- You have pain in the groin or scrotum, especially when you move or exert yourself. It can feel like an aching pain or as a short and stinging pain.
- You may have a feeling of weight or feel discomfort at the rupture.
- You may have a stomach ache.
The bulge can resize during the day
It is common not to notice the groin hernia in the morning, but during the day the hernia may become larger. Sometimes the hernia may just look like a swelling.
Often, the hernia is felt and seen more when you make movements that increase the pressure in the stomach. For example, it may be that you lift heavy, get up or cruise. In children, the hernia may be easier to see when the child cries or cries.
Children may get a lump in the groin for other reasons
A lump in the groin of children need not be a hernia. It can be, for example, an enlarged lymph node that swells in connection with an infection called a gland. Children may also have a stomach ache for other reasons.
Squeezed groin hernia
A groin hernia can develop into a trapped groin in both adults and children. But it can also be developed directly, without first having been a groin hernia.
A clamped groin hernia is usually clearly visible. It is then common to have several of the following symptoms:
- Very bad stomach, groin or scrotum. In younger children, it can be perceived that the child has a lot of stomach aches.
- A bulge or swelling in the groin that hurts and cannot be pushed back.
- The groin or scrotum turns red.
A squeezed groin hernia can cause bowel twists. It then hurts the stomach. Intestinal twitching may be the first symptom of squeezed groin fracture, as the hernia is not always felt earlier.
Children who have squeezed groin fractures can also get tired, uninterested in their surroundings and not make the same contact as usual. They can also vomit.
When and where should I seek care?
Contact a health care center if you think you or your child has a hernia. You can contact many receptions by logging in.
You can also contact a child care center if you think the child has a hernia.
If it’s in a hurry
If you think that you or your child has squeezed groin hernia, contact a health care center or an on-call reception immediately. If closed, seek care at an emergency room.
What can I do for myself?
There are some things you can do to relieve the hassle.
Try pushing the hernia back
Sometimes it is possible to push the hernia back temporarily. Move your hand over the hernia from below in the direction of the navel. The hernia can be pushed back more easily if you or the child is on your back with bent legs. The knees should be up.
Use painkillers if you are in pain
Painkillers can relieve it if it hurts. Examples of such are drugs containing the active substance paracetamol or ibuprofen.
You can buy them without a prescription at a pharmacy. Ask your pharmacist if you are not sure which painkiller to use.
Surveys
You can tell your doctor about your child’s symptoms. Then the doctor examines the groin to see if there is a swelling or lump. It is usually enough for the doctor to make a diagnosis.
It may happen that the hernia is not visible when it is time for the examination. It may suffice then to tell you that there may sometimes be a lump in the area where the hernia usually appears.
More research may be needed
The hernia may need further examination if the doctor is unsure of the diagnosis. Hernia in children may also need to be examined, although it is rare. You or the child will then receive a referral to one of the following:
- ultrasound
- computer tomography
- MRI
- an x-ray examination called herniorrhaphy.
Herniography is a special x-ray examination to see hernia. During the examination, you get a contrast liquid with a syringe in the stomach. When the x-rays are taken, you get to scream. The contrast fluid makes the hernia more visible on the X-rays.
Sometimes the doctor may want to examine the hernia with the laparoscopic technique, also called laparoscopy. You need to be anesthetized then because it is a form of surgery. An advantage of this form of examination is that the hernia can be treated at the same time.
Treatment of groin hernia
The only way to remove groin fractures is through surgery. But groin hernia does not need to be operated on in adults if it causes few or mild symptoms.
The hernia can relieve the symptoms
Adults can use a so-called hernia band, if it is a long time for the operation or if the hernia is not operable. The hernia band holds back the hernia. It can relieve the symptoms and prevent the groin from growing.
A groin hernia is always operated on in children
In children, groin hernias are almost always operated, whether they cause problems or not. This is because a groin hernia can more easily develop into a squeezed groin hernia as the child grows. How long a child has to wait for the surgery depends on the child’s age and what symptoms the child has.
Squeezed groin hernia may need surgery immediately
A pinched hernia almost always needs to be operated directly, both in adults and in children.
Sometimes a doctor can push back a pinched hernia in a child. Then the child does not need to be operated directly, but the operation can be planned and done at a later time. The child is given pain-relieving medication before the squeezed hernia is pushed back if needed.
Then the operation goes on
Operating a hernia is done in much the same way, whether it is a groin hernia or a squeezed groin hernia.
Children are always anesthetized before surgery. In the text When children are operated on in the stomach you can read more about how it works and how to prepare the child for the operation.
Adults can either be anesthetized, have a back anesthetic or have a local anesthetic. Which method it becomes depends, among other things, on what the noise looks like, how you feel and what you want.
Head hole technology or open surgery
You can be operated on with a perforation technique or the surgeon may choose to open the abdomen, a so-called open surgery. It is most common for the surgeon to operate with the peephole technique.
The surgeon can choose open surgery if there is a squeezed groin fracture and there is a risk of the intestines being damaged.
In adults, the abdominal wall is strengthened
During surgery, the surgeon returns the contents from the hernia to the abdomen. The surgeon then removes the hernia sac.
In adults, the abdominal wall is strengthened so that the hernia does not return. There are various ways in which the abdominal wall can be strengthened:
- Using the body’s own tissues. The surgeon sews them together in a special way. It’s called hernia plastic.
- Using a net consisting of a plastic material. The net is placed at the time of weakening. This type of augmentation is often done in puncture surgery.
- Using a net that is wound into a plug. The surgeon inserts the plug into the weakening of the abdominal wall. The plug is unfolded to a net when it is in place.
In children, the abdominal wall is not strengthened, as the rupture is usually due to an opening inside the abdomen not growing together properly. The surgeon sews the opening together, usually with stitches that disappear by themselves.
Good to quit smoking
There are many benefits to quitting smoking before an operation. Among other things, the wounds heal faster, and blood circulation and fitness improve. It makes you better faster.
It is best to quit smoking, but if it fails, it is good if you do not quit smoking before the surgery and the weeks after the surgery. There is help to get if you want to quit smoking.
After the surgery
Both children and adults can usually go home the same day they have had surgery if it was a planned operation. If there has been a rush to operate, both adults and children can stay in the hospital for a few days.
Some children may feel sick and vomit when they wake up. Therefore, the drip usually has to sit for a few hours so that the child does not get a fluid deficiency. The child gets the drip before surgery, during the dormancy.
Can hurt the operating wound
During the first day, it can hurt the wound. Then prescription pain tablets can relieve. If it still hurts after a few days, non-prescription painkillers can help.
Adults can get a small wheeze that is tender during the operation wound. The whale diminishes after a couple of weeks and eventually disappears completely. Occasionally, there may be a cure if a mesh has been used to strengthen the abdominal wall.
It can sometimes hurt to cruise for a while after the operation, for example when you are going to poop. Then it may be good to drink more water and eat more fiber-rich foods, to avoid constipation. In the texts Constipation and Constipation in children there are more tips on how you or the child can avoid being constipated.
Take it easy the first few days after surgery
It is good to avoid lifting heavy items in the first few days after surgery. This applies to both children and adults.
Children do not need any special rest after the operation, but it can be good to stay a little more still. Therefore, it may be good to stay at home someday from preschool or school.
The child may need to abstain from school gymnastics and sports for about a week. It is to avoid getting hit against the place where the child was operated, which can hurt. It can also be good to be a little careful in games and avoid jumping in a trampoline in the coming weeks after the surgery.
Adults who work may need to be on sick leave for a few days. Even adults may need to take it easy in the next few weeks after surgery.
Otherwise, it is good to try to live as usual after the surgery. For example, you can walk and cycle the day after the surgery.
The wound heals after just over a week
The surgical wound will be covered by a dressing. It is good if the dressing can remain until the wound has healed. It can take eight to ten days.
You can read more about how to take care of the wound in the text Operation wounds.
Visits are rarely needed
Most often, no return visit is needed after the operation. But if you or your child should suffer from the operation wound, you should contact a health care center.
Unusual to get hernia again
It is very uncommon for the hernia to return to childhood. If this happens, the child needs surgery again.
It is also uncommon for adults to get the hernia back in the same place as before. However, a new hernia may occur, but then in another place.
Exercise the muscles of the abdomen
You can reduce the risk of getting a new hernia by exercising the muscles of the abdomen. Start exercising gently about six weeks after surgery.
Talk to your doctor about what exercises to do.
Post-operative complications
The complications described below apply to both adults and children. Before you or the child leave the hospital, you will be informed about what to do if any of you have a complication.
Bleeding from the operating wound
It may start bleeding on the inside of the wound, inside the skin. The area around the wound then becomes bluish and very swollen. Usually, the bleeding stops on its own, but sometimes it can become so large that a surgeon needs to open the wound again to stop the bleeding.
The wound can become infected
An infected wound is usually marked two to four days after surgery. Then the wound becomes red, swollen and hurts. The skin around the wound can also feel warm. Sometimes it can come from the wound. You or the child may also have a fever.
The infection is due to the fact that bacteria have entered the wound.
An infected wound needs to be opened and reassembled. Often you or the child will also receive antibiotics afterward.
Testicular inflammation is uncommon
You may get testicular inflammation after surgery, although it is unusual. The first symptoms are that the groin and testicle on the operated side become red, swell up and hurt. It happens about a day after surgery.
The inflammation is due to the blood circulation to the testicle being disturbed during surgery.
The feeling in the operating area can change
Sometime after the operation, the feeling can sometimes become worse in the area of the operating wound. This may be because some of the nerves passing through the surgical area have been cut off during the operation.
The feeling usually gets better, but if it has not been there within a year it has disappeared forever. Having no feeling is usually not a problem.
Sometimes you may get hurt in the area where you operated. They can remain for a long time, sometimes for several months. It is very uncommon for children to have nerve pain after surgery.
What is it?
The cause of hernia in children and in adults differs.
Hernia in children is congenital
Fractures in boys occur during fetal development as testicles migrate to the scrotum through the so-called groin tract. The groin canal develops in all children in the fetal stage, regardless of gender. This means that girls can also get into trouble, although it is more unusual.
The testicles are formed during fetal time inside the body near the kidneys, at the level of the waist. As the testicles migrate down to the scrotum, they pull a long flap of the peritoneum through the groin. During the baby’s first two years of life, this flap of the peritoneum becomes thinner, eventually to become a thin membrane around the testicles.
A hernia can occur if the membrane does not become thinner. The membrane then remains as a sack that can be filled with abdominal contents. In girls, the ovary can collapse in the hernia.
A hernia can also occur if the tab that passes through the groin duct is opened.
Most common in children under two years
Fracture is most common when the child is under two years old, but it can also occur when the child is older. It is also more common in children born prematurely.
Fracture in adults is due to the abdominal wall becoming weaker
In adults, the abdominal wall of the groin may become weaker. There are several things that affect the abdominal wall and if a hernia is formed:
- Smoking impairs so-called supportive tissue. Examples of such tissue are connective tissue and tendon tissue.
- Heavy lifting for an extended period of time. Heavy lifting increases the pressure in the abdomen, which in turn can squeeze the hernia.
- Some diseases or injuries, such as nerve damage to the abdominal wall.
- Weaker tissues. This is partly due to hereditary factors.
- In the abdominal wall, there are openings at the groin, where the semen conductor with blood vessels goes to the testicles. Fractures can be formed there.
It is not entirely clear what the groin noise is due to. Sometimes it can occur without one of the above.
You should understand the information you receive
In order to be able to participate in your care and make decisions, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand. You can also ask to have the information printed to read it peacefully.
Children should also be involved in their care. The older the child, the more important it is.you may have the right to get interpretative assistance. You may also have the right to receive interpreting assistance if you have a hearing impairment.