
22/07/2025
Surgical repair of an inguinal hernia in a neonate is strongly recommended and typically urgent. Here are the key reasons:
🔴 1. High Risk of Incarceration
Neonates have a significant risk (up to 60%) of the hernia becoming incarcerated (where bowel or o***y gets trapped and can't return to the abdomen).
Incarceration can occur suddenly and unpredictably, even before a scheduled surgery.
🔴 2. Risk of Strangulation
Incarcerated hernias can progress to strangulation, where the blood supply to the bowel (or te**is/o***y) is cut off.
This is a surgical emergency and can lead to bowel necrosis, sepsis, or loss of the testicle/o***y.
🟠 3. Hernia Will Not Resolve Spontaneously
Unlike umbilical hernias, inguinal hernias never resolve on their own in infants.
They are caused by a patent processus vaginalis, which must be closed surgically.
🟠 4. Prevention of Future Complications
Early repair prevents recurrent emergency visits, pain, feeding problems, and parental anxiety.
Also reduces risk of damage to reproductive structures (te**is or vas deferens in boys, o***y or fallopian tube in girls).
🔵 5. Relatively Safe and Quick Procedure
Inguinal herniotomy in neonates is a routine, low-risk procedure in experienced hands.
When done electively, outcomes are excellent.
🟢 6. Special Urgency in Preterm Infants
Preterm infants have a much higher risk of incarceration.
Many centers recommend repair before discharge from the NICU, even if the baby is asymptomatic.