Inguinal hernia

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Discussed the need for emergency evaluation today. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Inguinal hernia
• Reducible groin bulge, consistent with an inguinal hernia
• Referred to pediatric surgery for prompt repair
• Follow up after the specialist visit

An inguinal hernia in a child does not go away on its own and is repaired soon after it is found, since bowel can get trapped in it and a testicle or ovary can be injured. Until the repair, the bulge may come and go, especially with crying or straining. Return precautions given including a bulge that stays out when the child is calm, a bulge that becomes firm, painful, red, or discolored, vomiting, fussiness that cannot be consoled, fever, bloody stools, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Reducible bulge
Bulge described at home only; photo helps
Incarcerated reduced in clinic; irreducible to the ED
Preterm (higher incidence, apnea risk); girls (ovary)
Pediatric surgery evaluation; urology
Prompt repair; delay of 14 days or more doubles incarceration under 1 year
Ultrasound only when the exam is unclear
Incarceration return precautions

Return precautions in the template

a bulge that stays out when the child is calma bulge that becomes firmpainfulreddiscoloredvomitingfussiness that cannot be consoledfeverbloody stools

Sources

HealthyChildren.org: Communicating Hydrocele
AAP Clinical Report, Assessment and Management of Inguinal Hernia in Infants (2012)
AAP News
Wang KS; COFN; Section on Surgery. Assessment and Management of Inguinal Hernia in Infants. Pediatrics 2012;130(4):768. Reaffirmed May 2021. (re-read Oct 22 2026,…