#MedicalCase

Uncertain bump in the pelvic area of a 5-year-old. (Child Health)

Dr. Albana Greca., MBBS, MMEDSC

 

Medical Case Details:

Hello, I have this case of my patient, a 5-year-old female child. For a couple of months, especially last month's appointment, I was able to note a bump (hernia like) on the right side pelvic area, which is not always present. The child does not complain of any pain or anything. The child is a little bit terrified when we check with her mother, but nothing else. When she was two months old, we noted an inguinal hernia on the left side, and that subsided within the first year. At that time, we have also consulted the urologist, who said there was no hernia on the right side. Did we miss anything? Or can this appear suddenly? I will send her for an ultrasound, but due to the pandemic, I do not want her to travel unnecessarily. I was thinking of possible vaginal enlargement as the child is taller than her age (shows 8 years old instead of 5). But, at times, the bump is seen only on the right side alone and sometime later on both sides. Also, at some point, there is no bump at all. Can you help? Thank you in advance for your input.

 


    Discussions


    Dr. Prakash Nagar
    Child Health Specialist

    In a female child, direct inguinal hernia is a possibility and USG only will confirm it. Is there any cough reflex? If it possible, please post a photograph. 3 yrs advanced height is significant and need to look for any other signs & symptoms including arm span, tanner staging, skin & eye lesion etc.
    Its interesting , please keep updating.

    ▲ 1
    09.Sep, 06:23pm

    Dr. Manu Bharadwaj
    Paediatric Surgeon

    Hello Dr Greca,

    There are a few interesting things about your case. First, Inguinal Hernia usually does not get better on its own with age. So, probably there was no Hernia during the infancy (baby’s groin fat can be easily mistaken for Hernia) OR, she has a hernia but did not manifest the swelling during your examination now OR she has undergone Herniotomy.
    Second, when you say the right pelvic area, do you mean Inguinal region OR swelling above the Inguinal ligament OR like a femoral Hernia?
    Third, why is there any doubt about the size of the Vagina? Is the bump that you mentioned is on the right side of the perineum?
    In any case, an Ultrasound examination is definitely warranted. Please post the report here.

    ▲ 1
    09.Sep, 06:23pm

    Dr. Albana Greca
    General Practitioner

    Hello Dr.Prakash and Dr.Manu,

    Thank you for your valuable input.

    I'll call the child for tomorrow's appointment in my clinic and run the measurements and physical exam as requested by you.

    She has not undergone any herniotomy, no surgical intervention since birth she was my patient. Only seasonal colds.

    I am sorry for my mistake, I meant inguinal area, the bump is not always visible, I hope it will be at my tomorrow's appointment.

    I will try to send a photo of the area (hope it will be visible) as I find it difficult to describe by words.

    I'll send for ultrasound and for sure will attach the report once I get them hopefully.

    Thank you in advance again. I'll keep you updated for sure hopefully.

    09.Sep, 06:30pm

    Dr. Raees Tonse
    Radiation Oncologist

    We can get an Ultrasound done. Then assess further, may require a MRI scan too

    ▲ 1
    11.Sep, 07:15pm

    Dr. Albana Greca
    General Practitioner

    Hello

    Ultrasound already confirmed inguinal hernia. Pt scheduled for herniotomy on March.

    Thank you. I'll keep you updated.


    14.Feb, 08:49pm



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