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  1. #1
    Join Date
    Jun 2005
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    Texas
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    Default Hernia repair in infants

    My 4 month old DS was diagnosed with a hernia today. I honestly don't know much about it. Our ped said if it isn't better by his 6 month check up she will need to send us to a surgeon to have it repaired. It is located in his "boy" area and is a pretty good size by the docs standards. Does anyone know anything about the surgery to repair hernias in this location? I can read and read on the net but was looking for someone with some personal experiance.
    Brian & Cindy - March 15, 2003
    Kaylea - Nov. 29, 1997 Lauryn - March 30, 2004
    Nathan Lee - Aug. 22, 2006 -- 8lb 3oz, 20 1/4 inches

  2. #2
    Join Date
    Jun 2005
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    Hi! I'm hoping someone who's DC has gone through the surgery will post, but I can give you a somewhat objective response as a surgeon (I'm not a pediatric surgeon, but assisted on a lot of these as a resident. I wasn't a mom then, though, so probably didn't pay as much attention to the mom issues as I would now! But enough of the disclaimer).
    So...at my hospital the mom would be able to come into the OR with the child, and hold him/her while they put a mask over his face and he'd go to sleep with the gas. She would then leave, and then they'd put in an IV. The surgery itself is pretty quick and ped surgeons do a TON of them. I'll let the surgeon tell you the details. Your baby will wake up in the OR and be brought to the recovery room where they usually have you come right when they're finished. After that I don't know from the mommy standpoint, and I'm not sure if there were different rules from when my DS had tubes put in his ears (which is literallly 5 minutes; the hernia could take up to an hour but usually not). For my DS they let me nurse right away; they'd probably want to see your son drink some clear liquids first before the milk or formula. We usually gave the baby a prescription for tylenol with codeine (elixir) for pain to go home with. I don't know how the babies did afterwards, so again I hope someone with personal experience answers! We always put disposable stitches in so there was nothing to do for the wound (there would be those little steristrips over that but those would usually fall off after a week or so).
    I don't think inguinal hernias (that's what it's called) ever go away on their own, if that's in fact what it is. That's different from an umbilical hernia (in the belly button) which in a baby sometimes does go away and may not need surgery. Sounds reasonable for your ped to refer to a surgeon. Oh, one last thing...if your baby was premature they may observe him overnight just because they sometimes have breathing issues. Also, sometimes they occur on both sides, and some surgeons would look at the other side at the same time (with a camera, called a laparoscope) and then fix the other side if a hernia is present there.

    Ok, hope this was helpful and not too vague or too medical! I feel for you; I know any surgery on your child is really scary but hopefully others can give you some reassuring words and the surgeon can explain everything!!
    Wow -- I have a son! 9/2/05
    BABY GIRL 2/20/08!!

  3. #3
    Sebski Guest

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    Last edited by Sebski; 12-31-2007 at 10:38 AM.

  4. #4
    Sebski Guest

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    Last edited by Sebski; 12-31-2007 at 10:38 AM.

  5. #5
    Join Date
    Jun 2005
    Location
    Texas
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    pgbg - Thank you very much for all the info!!!! Our doc didn't act like it was something that would really go away. I think she was trying not to scare us by saying they will give it a little time to see what happens. We also found out today he has RSV so we had a lot of stuff to talk about. Thank you so much for telling me the name of it. It sounds familiar now that you say it. Maybe she did tell me and I couldn't remember. Do you think this is something that should be fixed sooner then later? Should I wait until he is 6 months old or go ahead and ask for referral to a surgeon now?

    Sebski - Thank you for your insight!! I really appreciate it. Glad to hear your DS handled things so well. Both of my DS testicals have descended and appear fine but it seems like the surgery would be very similar. Congrats on #2&3!!! How exciting!!
    Brian & Cindy - March 15, 2003
    Kaylea - Nov. 29, 1997 Lauryn - March 30, 2004
    Nathan Lee - Aug. 22, 2006 -- 8lb 3oz, 20 1/4 inches

  6. #6
    Join Date
    Jun 2005
    Location
    St. Paul, MN
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    Well, for personal experiences, I had it done as a baby. Can't tell you anything about it except that I obviously can't remember it, and your DS won't either
    Eve Eleanor arrived June 5, 2007
    Graham Alexander arrived February 27, 2010
    George Derek arrived October 17, 2014

  7. #7
    Join Date
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    Location
    Texas
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    That is the only good thing about procedures on babies. They will never remember it.
    Brian & Cindy - March 15, 2003
    Kaylea - Nov. 29, 1997 Lauryn - March 30, 2004
    Nathan Lee - Aug. 22, 2006 -- 8lb 3oz, 20 1/4 inches

  8. #8
    Join Date
    Jun 2005
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    I'm back w/ some stuff I cut and pasted from a pediatric surgery text book...

    The incidence of inguinal hernia is highest during the first year of life, with a peak during the first months. Approximately one third of children with hernia are less than 6 months of age at operation. The incidence is highest in premature infants, with reports ranging from 16% to 25%.

    The predominance of right-sided hernias is well established. Rowe and Clatworthy[90] reported that in boys 60% of hernias occur on the right side, 30% on the left, and 10% bilaterally.

    An inguinal hernia does not resolve spontaneously and must be repaired because of the high risk of incarceration, particularly during the first months of life. Sixty-nine percent of incarcerated hernias occur before the age of 1 year, and in these younger patients, the hernia tends to be irreducible. Rowe and Clatworthy[89] found that 71% of incarcerated hernias requiring operative reduction occurred in infants younger than 11 months of age.

    In most patients, elective inguinal hernia repair is safely done in the outpatient surgical unit. Exceptions are high-risk newborn infants (discussed later) and older children with cardiac, respiratory, or other disorders that increase the risk of anesthesia. These patients may be admitted either the night before or on the morning of operation and are kept in the hospital overnight for observation and monitoring.


    You might want to get the referral to the surgeon now, if only to talk to someone in person and maybe get some peace of mind (or to have them schedule the surgery sooner if they think it should be). The only real risk of him having the hernia is that "incarceration" mentioned above -- that means that a piece of intestine can slide down into the hernia and get stuck. Your DS would have a lot of pain, he might be vomiting, and there would be a bulge there that didn't go away when he lay down. Now, if he's relaxed and laying down, you may not see the bulge until he strains or cries (because that increases pressure in his abdomen which pushes fat or fluid or whatever down into the hernia). If you're able to push the bulge back in, that means it's "reducible", vs. "irreducible" which means it's always sort of stuck (and thus the higher risk of incarceration as mentioned in the text). The RSV may or may not push him into the "high-risk" category, but your pediatrician and the surgeon would certainly be able to answer that. Good luck!
    Wow -- I have a son! 9/2/05
    BABY GIRL 2/20/08!!

  9. #9
    Join Date
    Jun 2005
    Location
    Texas
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    pgbg - I can't thank you enough for all your help and information! The doc had never noticed the hernia until our WBV yesterday. DS was laying down and smiling away and it could be easily seen once she pointed it out to me. I've called our ped back this morning about getting into a surgeon now at least for a consult and am still waiting to hear back from her. DS was only 2 weeks early so he wasn't considered premature and he was over 8lb. The only thing is my originall due date was 4 weeks after he was born. They moved my due date up 2 weeks when I was around 17 weeks pregnant because of his u/s measurments. He also has a severe reflux. I've done some searching and found this can by a symptom of the hernia. I'm really hoping we can get into a surgen right away and get a better understanding on what is going on. Thanks again for all your help. I really appreciate it.
    Brian & Cindy - March 15, 2003
    Kaylea - Nov. 29, 1997 Lauryn - March 30, 2004
    Nathan Lee - Aug. 22, 2006 -- 8lb 3oz, 20 1/4 inches

  10. #10
    Join Date
    Feb 2007
    Location
    Upstate, NY
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    Just thought I'd bump this up. My DS was 13 months when I discovered his hernia -by that time it was incarcerated and required an ER trip - The Dr was able to reduce and surgery was done the following morning -very scary stuff -nt to mention extremely painful for the little guy!

    Anyway, his surgery was on 12/7/10-we've had him on Miralax since so that we can avoid constipation since straining is very not desired after surgery. I don't have his follow-up appointment until 1/10 & it can't come soon enough! In the weeks leading up to the problems with the hernia we thought that we were dealing with constipation -he would get extremely cranky and clingy until he had a BM. When I took him to the ER, the surgeon did ask me how long he had had the hernia and I told him that I had not noticed it before -the bulge was huge and hard -very difficult to not notice the day I took him in & I took him immediatly when I noticed it-I didn't know what it was, but I had a very sick baby and it was just not right. In hindsight I did recall a few days afterwards that I did see a bulge in his groin area when I changed his diaper but it seemed to go away as I changed him and I wasn't sure what I was seeing -that was probably several weeks to taking him to the ER -I never saw it again and I did mention it to my DH & DCP, but neither saw anything like that either.

    Now we are once again dealing with crakiness and clinginess until he poops. My fear is that he has another hernia, but I have not been able to see anything. Has anyone dealt with this? Does anyone know if there is anyway that they can diagnose a hernia without seeing a bulge?

    He was not premature, but 9 days overdue. He did have an undescended testicle, but the hernia was on the opposite side -the surgeon frown when I told him the undescended testicle was on the other side. I'm on pins and needles everytime he doesn't poop first thing in the morning and gets all clingy -the DCP called me this morning and said all he wants is to be held and will not play.

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