(Hons), DipAnat, Surgical Resident, Department of Paediatric Surgery, Monash Children@s Hospital, Vic.
MBBS (Hons), MD (Res), FRCS (Paed Surg), Consultant Paediatric and Neonatal Surgeon, Department of Paediatric Surgery, Monash Children@s Hospital, Vic; Senior Research Fellow, Department of Paediatrics, School of Clinical Sciences at Monash Health, Medicine, Nursing and Health Sciences, Monash University, Vic.
Aust J Gen Pract. 2020 Jan-Feb;49(1-2):38-43. doi: 10.31128/AJGP-08-19-5037.
An inguinal hernia is one of the most common paediatric surgical presentations in a primary care setting. Hernias can present in multiple ways, ranging from an emergency such as a strangulated hernia to a less urgent reducible hernia.
The aim of this article is to aid in appropriate diagnosis and management of hernias in children. The article also provides useful tips for hernia reduction that are especially beneficial in the primary care setting and assist with the identification of hernias that require urgent referral.
Recognising the signs of a hernia containing compromised contents is essential to prevent serious complications such as intestinal perforation, testicular atrophy and ovarian damage. Other common conditions such as hydrocoele and undescended testis are sometimes confused with an inguinal hernia. Young patients under the age of three months and patients with concern for compromised contents require urgent referral. Recent evidence regarding controversial issues in inguinal hernia repair such as the role of laparoscopy and the relevance of a contralateral patent internal inguinal ring will be discussed.
腹股沟疝是小儿外科中最常见的病症之一，在初级保健环境中较为常见。疝可以以多种方式出现，从急症（如嵌顿疝）到不太紧急的可复性疝。
本文旨在帮助对儿童疝进行适当的诊断和治疗。文章还提供了一些有用的疝复位技巧，这些技巧特别适用于初级保健环境，并有助于识别需要紧急转诊的疝。
认识到疝内容物受损的迹象至关重要，以防止严重并发症，如肠穿孔、睾丸萎缩和卵巢损伤。其他常见疾病，如精索鞘膜积液和隐睾，有时与腹股沟疝混淆。年龄在三个月以下的年轻患者和有内容物受损的患者需要紧急转诊。本文还将讨论腹股沟疝修补术方面一些有争议的问题，如腹腔镜的作用和对侧未闭的内环的相关性，这些问题都是基于最近的证据。
