TY - CHAP M1 - Book, Section TI - Inguinal Hernia A1 - Shah, Ashish A1 - Sobolewski, Brad A1 - Mittiga, Matthew R. A2 - Knoop, Kevin J. A2 - Stack, Lawrence B. A2 - Storrow, Alan B. A2 - Thurman, R. Jason PY - 2021 T2 - The Atlas of Emergency Medicine, 5e AB - Inguinal hernias are common in childhood with an incidence as high as 5%. Premature infants have an even higher incidence, and boys are approximately 10 times more likely than girls to develop an inguinal hernia. There are two types of inguinal hernias: indirect (common) and direct (rare). Indirect inguinal hernias result from failure of the processus vaginalis to obliterate toward the end of fetal development. With a patent processus vaginalis, the intra-abdominal viscera can protrude through the internal inguinal ring. Indirect inguinal hernias are more common on the right and present as a bulge in the groin by parental history or on physical examination. Maneuvers that increase intra-abdominal pressure, such as crying in an infant or blowing bubbles in an older child, may make the hernia easier to visualize. Associated symptoms such as vomiting, abdominal distention, constipation, blood in the stool, lethargy, or irritability suggest incarceration or strangulation of the hernia. Incarceration is most common in the 1st year of life. The differential diagnosis includes hydrocele, inguinal lymphadenopathy, testicular torsion, torsion of the appendix testis/epididymis, epididymitis/orchitis, and a retractile testicle. SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/04/19 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1181044681 ER -