Hello Mr. Wuori.
Thank you for your query at DoctorSpring.com.
Your son seems to have Congenital Hernia. In this type, there will be a communication between abdomen and scrotum. However, most of the times, this passage of communication is narrow, which allows only fluid from abdomen into scrotum leading to fullness in the scrotum. Intestines enter into the hernial sac and get strangulated very rarely in this congenital variety.
Any hernia has to be operated including congenital hernia.
If an experienced Paediatric surgeon is available along with good anaesthesia facilities, the child can get operated now itself. Planned surgery is always better than an emergency surgery.
There is no specific time for hernia surgery.
We cannot predict the strangulation. However, in children with narrow communication, it is rare.
You can consult a senior paediatric surgeon in nearby town, take his opinion and proceed further.
Nothing to worry.
I hope this was helpful. Feel free to ask queries.
Wishing him good health,
Regards.
Patient replied :
Dear Doctor,
Thank you for your reply. It was helpful. As I previously wrote, the hernia was measured as 1.31 centimeters by the ultrasound. Is this considered a narrow communication? When the scrotum increases in size, it is very hard and does not feel like liquid because it is so hard. Does the hardness indicate that more than fluid is passing into his scrotum, perhaps part of the intestine? If I understand your answer correctly, you are stating that it is no more risky to have the surgery now when the baby is less than 2 months old, than four months from now when he will be 6 months old. Is this correct, that there is no greater risk of complications by operating on a 2 month old baby than a 6 month old baby? Again I thank you for your help.
Steve
Hi. Thank you for writing to us again.
The measurement of 1.3cms is confusing. Hernia which is of 1.3cms long will not extend into scrotum.It could be the diamter of the neck of the hernial sac.IF the neck is narrow,it does not allow any abdominal content to enter into the scrotum.If the neck is 1.3cms,it can allow part of the intestine,mostly small intestine as it is freely mobile.But,the intestine will be soft to touch.Another content of the abdomen called Omentum(fat) can enter the hernial sac upto the scrotum.It will be hard.Any content can go inside the abdomen when the neck of the hernial sac is wide.
There should be well equipped operation theatre,good/senior anaesthetist who can give anaesthesia to months child,senior paediatric surgeon to do surgery in a 2months old child.So,if all the above criteria is fufilled ,you can proceed with surgery even at 2 months .
Wish him good health,
Regards
Patient replied :
Doctor,
Your information has been very helpful. I have 3 final questions. We have found a great hospital with an anesthesiologist and experienced surgeon. First, do you recommend that we have surgery now or do you recommend that we wait until the baby is older? Second, which anesthesia is best for a 2 month old baby: general, spinal, or local? And third, which surgery for a 2 month old baby is better, hernioplasty with mesh, or herniorrhaphy without mesh? Thank you so much doctor. You have been a blessing to my family in this difficult time.
Steve
Hello. Thank you for writing to us again.
1.In my opinion, you can wait for few more months for surgery of your child.
2.If you want to go for surgery now,General anaesthesia is best for 2 months old child.
3.For 2 years old child, we do Herniotomy , i.e. Excision of hernia sac.There is no need for herniorrhaphy which is done in young adults and Hernioplasty which is done in old age people.
Feel free to ask further questions,
Regards