Specialty: Children's surgery
Age group: Children
Direct to an emergency department
- Suspected hernia with symptoms suggestive of strangulation or incarceration including acute abdominal pain, pain on palpation, redness, nausea, vomiting
- Symptoms suggestive of bowel obstruction including acute abdominal pain, abdominal distension, nausea, vomiting.
Criteria for referral to public hospital service
- Umbilical hernia in a child older than 4 years
- Umbilical hernia that has been present for more than 2 years that is greater than 1.5 centimetres in diameter
- Other abdominal wall or groin hernia felt on examination or that is clinically evident.
Information to be included in the referral
Information that must be provided
- Reason for referral and expectation or outcome, anticipated by the patient, or their carer, and the referring clinician from referral to the health service
- Detailed clinical examination including the position and size of the hernia
- Child’s age.
Provide if available
- Statement about the parent(s) or guardian’s interest in having surgical treatment if that is a possible intervention
- If the child identifies as an Aboriginal and/or Torres Strait Islander
- If the child is neurodiverse, gender diverse or has a disability
- If the child has a preferred language other than English and if they rely on cultural or linguistic support (e.g. Aboriginal cultural support, an interpreter)
- If the child lives in out-of-home care (foster care, kinship care, permanent care or residential care)
- If the child is aged 14-18 years, do they consent that their health information is shared with their parent, guardian or carer.
Additional comments
The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.
Diagnostic imaging has no role in the assessment, measurement or management of abdominal wall, groin and umbilical hernias in children (except for femoral hernias). Imaging reports do not inform the assessment of referrals and unnecessary imaging adds to parenteral concern.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for
- Incidental hernias found on imaging without symptoms or clinical significance.
Reviewed 12 August 2025