🩺 Chapter 394: Inguinal Hernias

Nelson Textbook of Pediatrics 22nd Edition — Indirect inguinal hernia is caused by patent processus vaginalis. Presents as intermittent groin/scrotal bulge. Highest incidence in premature infants and first year of life. Incarceration risk: up to 30% in infants <6 months. Treatment: elective herniorrhaphy (open or laparoscopic) after diagnosis. Incarcerated hernia: reduction (manual or operative), then repair.

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📋 30 Clinical Scenarios — Inguinal Hernias

📇 High‑Yield Review Cards (Inguinal Hernias)

🩺 Clinical Presentations: Inguinal Hernias

Select a presentation for diagnostic clues and management.

📋 Stepwise Evaluation & Management of Inguinal Hernias

🔑 Key Principles — Inguinal Hernias (Nelson Ch.394)
• Indirect inguinal hernia: Patent processus vaginalis (congenital). 99% of hernias in children.
• Incidence: 3-5% in term infants, up to 30% in premature infants. Male:female 8:1. Right side more common.
• Presentation: Intermittent inguinal/scrotal bulge that increases with crying/straining. Often reducible.
• Incarceration: Non-reducible hernia, risk highest in first 6 months of life (30%). Can progress to strangulation (ischemia).
• Treatment: Elective herniorrhaphy (open or laparoscopic) after diagnosis. Incarcerated hernia: manual reduction (with sedation), then repair within 24-48 hours. If not reducible → emergency surgery.

    ⚡ Reflex Prompts — Inguinal Hernias

    📖 Inguinal Hernias — Core Summary (Nelson Ch.394)