Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ Most often indirect Occur more frequently in boys than in girls (9:1) May present at any age Incidence in preterm male infants is close to 5% and is reported in 30% of male infants weighing 1000 g or less +++ Clinical Findings ++ Painless inguinal swelling Parents may be the only one to see the mass, since it may retract when the infant is active, cold, frightened, or agitated Clinical clues History of inguinal fullness associated with coughing or long periods of standing Presence of a firm, globular, and tender swelling, sometimes associated with vomiting and abdominal distention Herniated loop of intestine may become partially obstructed leading to severe pain Rarely, bowel becomes trapped in the hernia sac, and complete intestinal obstruction occurs Gangrene of the hernia contents or testis may occur In girls, the ovary may prolapse into the hernia sac presenting as a mass below the inguinal ligament +++ Diagnosis ++ A suggestive history often is the only criterion for diagnosis, along with the "silk glove" feel of the rubbing together of the two walls of the empty hernia sac +++ Treatment ++ Manual reduction of incarcerated inguinal hernias can be attempted after the sedated infant is placed in the Trendelenburg position with an ice bag on the affected side Manual reduction is contraindicated if incarceration has been present for more than 12 hours or if bloody stools are noted Surgery is indicated if a hernia has ever incarcerated Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth