It is a hernia in the groin or scrotum - sometimes called a scrotal hernia.
A hernia occurs when an organ pushes through to somewhere it is not supposed to be.
A hernia in the inguinal (groin) region occurs when some bowel from the abdomen pushes through into the groin (scrotum).
An inguinal hernia can look like a swollen testicle (testes) or it can look like a swelling in or above the groin.
The photo on the right shows a swelling above the groin on the baby's right side - put the mouse over the photo to see clearly.
Other causes of a swollen testes (testicle) are given at the bottom of the page.
Why do you get hernias in the inguinal region?
Hernias in the inguinal region usually occur in boys. The tissue that separates the abdominal contents from the groin contents (ie. the testicles etc in the scrotum) has a small opening (the inguinal ring) that lets blood vessels and nerves pass through. Sometimes, the tissue around this small ring is weak and bowel can push it's way through as well.
What is the problem with having an inguinal hernia?
If the hernia occurs somewhere where the bowel has to squeeze through (like the inguinal ring) but then it has room to expand (like in the scrotum) it can get stuck. If the bowel just moves into the scrotum and back out, it isn't a problem. If it gets stuck, it is a problem - we call that a strangulated hernia.
Why is a stangulated hernia serious?
If the bowel gets stuck, eventually the blood supply to the bowel will not be able to get through. Without a good blood supply, the bowel may die. If the bowel wall dies, contents leak out - this is a perforated bowel. It can be life-threatening.
How do I know if my baby has an inguinal hernia?
A baby with an inguinal hernia will have a swollen, firm scrotum. Sometimes, you may just notice that the scrotum is occasionally swollen and at other times, it isn't. This is probably a case where the hernia can slip back and forward. Your baby doesn't need an urgent operation but he will need to see a surgeon to get this fixed. See your doctor soon.
How do I know if my baby has a strangulated hernia?
If the bowel is stuck in the groin, this can cause a blockage - this can cause babies to vomit. It is painful so babies cry. Crying means it is more difficult for the hernia to reduce (for the bowel to go back where it belongs) because crying increases the pressure in the abdomen. The scrotum will look very tense and may be red.
What do I do if my baby has a stangulated hernia?
Try and keep your baby calm - crying only makes it worse. Try putting a cushion under your baby's bottom and keep his legs up - this is to get gravity to help put the hernia back. Call your doctor and arrange to get to a hospital. Your baby is likely to need an urgent operation.
What happens in an inguinal hernia repair operation?
For an experienced surgeon, this is a minor operation. Usually mesh is put over the weakness at the inguinal ring to stop any bowel from getting through. Babies tolerate this surgery very well.
Can girls get inguinal hernias?
Not usually. Sometimes girls can get a hernia into the groin - just in the crease at the hip on the top of the leg. This is usually called a femoral hernia. If a girl had one of these on both sides, we would investigate further as it's an unusual situation.
What are the causes of a swollen testicle?
A swollen testicle (testes) can be due to:
- an inguinal hernia - the gut in the scrotum can make the testicle seem swollen
- a hydrocele - this is fluid around the testicle. It usually gets better by itself but if it persists after one year of age, surgery may be required. It can be associated with a hernia as well
- a tumor - these can cause the testicle to look swollen and can occur in babies although they are rare