Dr. Ton Thi Anh Tu, a Master of Science and Level I Specialist Physician in the Department of Pediatric Surgery at Tam Anh General Hospital Ho Chi Minh City, diagnosed Trung with a right inguinal hernia. This condition is common in premature infants. An inguinal hernia occurs when the patent processus vaginalis fails to close after birth, allowing intestines or other abdominal organs to descend into the groin or scrotum, forming a bulge. The condition will not resolve on its own without intervention because the patent processus vaginalis remains open and the abdominal wall is weak. While the bulge may disappear when the child lies down, the hernia defect persists, posing risks of bowel descent, incarceration, or ischemic bowel.

An ultrasound of the groin revealed fluid measuring approximately 10x32 mm within the right inguinal canal, though no bowel descent was observed at that time. Blood and coagulation tests were within safe limits for surgery. Doctors recommended early surgery to prevent the progression of bowel descent, which could lead to incarceration or obstruction, potentially affecting testicular blood supply and future reproductive function.

After administering general anesthesia, the surgical team made an incision along the natural groin crease, exposed the inguinal canal, and carefully separated the hernia sac from the spermatic cord to avoid damaging blood vessels and the vas deferens. Subsequently, the hernia sac was ligated high at its neck, and the patent processus vaginalis was closed.

The pediatric surgeons operating on Trung. Photo: Tam Anh General Hospital

One day after surgery, Trung recovered well, resumed normal eating, and was discharged from the hospital.

Dr. Tu stated that the incidence of inguinal hernia in full-term infants is estimated to be 8-50 per 1,000 children, whereas in premature infants and those with very low birth weight, it can be as high as 20-30%. The current common treatment method is minimally invasive surgery to close the patent processus vaginalis, which is the cause of the hernia. The surgery is brief, the incision is small, and most children can be discharged on the same day or one to two days later for premature infants or those with co-existing conditions.

Dr. Tu advises parents to observe their child's groin and scrotal area during bathing or dressing. If a bulge in the groin or scrotum becomes prominent when the child cries, coughs, strains, or engages in strenuous activity, and does not recede when lying still, or if the child experiences excessive crying, vomiting, or abdominal distension, they should take the child to the hospital immediately.

Minh Tam

* Patient's name has been changed