Hernia in children: operation, consequences, causes
Unfortunately, in modern pediatrics, the hernia of the inguinal is often diagnosed in children. Sometimes an operation is the only possible way of treatment. Of course, this pathology causes great concern for parents. That is why many are interested in questions about what a hernia is and what the mechanisms of its formation are. How dangerous can an ailment and what treatments modern medicine offers? What are the causes of the development of pathology and what external features is it accompanied? The answers to these questions will be interesting and useful to many readers.
What is a hernia?
This pathology is considered quite common in pediatric surgery. Inguinal hernia is a protrusion of the contents of the abdominal cavity outward through the inguinal canal. Internal organs, for example the loop of the small intestine, the ovaries, the large omentum, bulge through the muscles of the abdominal wall.
It should be said that this pathology is more often diagnosed in newborn males, and premature babies are at increased risk. In most cases, the hernia can be diagnosed fairly quickly - it has the appearance of a slight swelling in the groin area, with a more prominent hernial bag becoming upright. The hernia responds well to treatment, especially if it was diagnosed at an early stage. Nevertheless, it is worthwhile to study in more detail the causes and symptoms of this pathology.
The main reasons for the development of inguinal hernia in a child
Many parents ask a question about why a child has a hernia. Reasons can in fact be very different. Here is a list of the most common risk factors:
- Quite often the cause is underdevelopment of the abdominal wall.
- Risk factors include physical overstrain. Naturally, when it comes to a child, the tension is not related to physical activity or lifting of gravity. With weakness of the abdominal wall, protrusion of the abdominal cavity organs may appear as a result of severe coughing or vomiting.
- Sometimes a hernia is the result of a trauma to the abdominal wall, including the period of intrauterine development.
- This pathology can be the result of overweight in a child.
Pathogenesis of the disease
As mentioned, the hernia is more often diagnosed in boys, which is associated with the peculiarities of anatomical development. Initially, the fetal testicles are located in the kidney area. Closer to the birth, they descend into the scrotum, carrying a part of the peritoneum behind them. Thus, a kind of pocket is formed in the scrotum, the basis of which is connective tissue. Normally, the pocket is overgrown by the time of birth. But sometimes this does not happen for one reason or another. The presence of a pouch increases the likelihood of bulging internal organs.
In addition, the inguinal canal in men is much longer than in women, which also increases the risk of developing a hernia. As for girls, their pathology is associated, as a rule, with the weakness of connective tissue, as well as physical overstrain. It is worth noting that the hernia can be congenital or begin to develop after the birth of the child. The protrusions may appear with one( more often with the right) and with both sides. Sometimes, children are diagnosed with a post-operative inguinal hernia, although in reality cases of relapse with a properly performed procedure are minimal.
What are the symptoms of the disease?
It should also be noted that the signs directly depend on the degree of protrusion. Typically, the hernia is a small, oval, sometimes triangular-shaped sac located either above the pubis, or on the outside of the pubic bone. Convexity, as a rule, becomes more noticeable in an upright position. The hernia also increases with increasing intra-abdominal pressure, which is observed, for example, during crying or crying.
Sometimes it causes severe pain of paroxysmal nature. Soreness makes the child restless, he often cries, does not sleep well. Symptoms include nausea, loss of appetite, and vomiting.
In the case of boys, the inguinal hernia is capable of shifting towards the scrotum( it is called an oblique hernia).In such cases, there may be an increase in the scrotum, swelling in the perineal region.
Now you know how the inguinal hernia in children is determined. The operation is not necessary in all cases. Nevertheless, if you notice any alarming symptoms, then the baby should immediately show the surgeon. The earlier the diagnosis is made and the treatment is started, the less likely the development of complications.
Complications arising in the background of a hernia
In fact, inguinal hernia is a serious enough problem. If the child was not provided with qualified medical care, then over time the protrusion of the abdominal organs becomes more pronounced. Against the background of pathology, a violation of normal blood circulation is possible, which entails a delay or irregular development of organs. In boys, the pathology of the reproductive system can be a consequence of a hernia.
Nevertheless, the most dangerous complication of inguinal hernia is its infringement. This situation is associated with tissue clogging and the violation of normal circulation in one or another organ. In turn, this situation is fraught with tissue necrosis, inflammation, infection of blood, etc.
Infringement and its symptoms
Infringement of the hernia - the situation is critical, especially when it comes to a small child. In such cases, surgery is simply necessary. To provoke the infringement of the hernia may increase the abdominal pressure, which, for example, is observed with severe crying and crying, physical exertion, coughing, vomiting, etc.
It is quite simple to determine the presence of an infringement. The hernial sac becomes more convex and firm to the touch. Palpation causes soreness. The child becomes restless, often cries, screams. Often the skin around the hernia acquires a reddish tinge. Along with this, there are also systemic signs, in particular, a rise in body temperature, fatigue, loss of appetite, vomiting, drowsiness, irritability. If you notice such symptoms in your baby, you need to immediately deliver it to the hospital, as the lack of qualified care can lead to massive necrosis, pain, shock, etc.
Modern diagnostic methods
It is possible to suspect the presence of pathology already during the general examination. The hernial sac becomes visible in an upright position, as well as during coughing, crying, etc. When palpating the doctor can feel for a soft elastic formation. By the way, sometimes a hernia can be corrected - put internal organs back inside. Naturally, a specialist should carry out the procedure, and not all convexities can be manipulated. If the inside of the bag contains part of the intestine, then you can hear a characteristic rumbling sound.
In the future, ultrasound examination of the abdominal cavity or pelvic organs( in girls) is usually carried out. Only after this, the doctor can decide whether surgery is necessary to remove the hernia.
In the event that a specialist decides to perform a surgical procedure, a more detailed medical examination is needed, which includes general blood and urine tests, an analysis for ESR and coagulation. Sometimes an additional irrigography is carried out - an x-ray examination of the intestine with a special contrast agent. As a rule, a barium suspension is used as a contrast. The procedure allows to determine the presence of pathologies or abnormalities in the development of the large intestine.
Are there effective methods of conservative treatment?
Immediately it is necessary to say that conservative therapy is possible only in cases when pathology was detected in the early stages. According to statistics, the disease in newborns can sometimes be eliminated without surgical procedures.
Quite often, doctors recommend wearing a special groin bandage. It is put on after the hernia has been corrected. This device supports the abdominal wall and keeps the internal organs from protrusion. As a rule, the groin bandage is worn in the daytime. Nevertheless, it can be left for the night if the child, for example, suffers from a night cough.
The bandage is not an alternative to surgical intervention, but merely a temporary measure. A small patient is also prescribed regular massage and special therapeutic gymnastics. These procedures are aimed at strengthening the abdominal wall. Even if the therapy gives a positive result, the child's condition needs to be carefully monitored, since the probability of relapse in the first 4 years of life is high.
Hernia in children: operation
Sometimes, without surgical intervention with a similar pathology simply can not do. This procedure is usually carried out at the age of 6-12 months. Its essence is quite simple. With the help of special tools the doctor disconnects the hernial sac and abdominal cavity. In this case, you need to ensure that the internal organs remain in place. Surgical intervention is performed under general anesthesia and lasts about 30 minutes. This is what the inguinal hernia operation looks like. Feedback indicates that the procedure gives really good results.
Naturally, in this case it is extremely important to find a good surgeon. Despite the fact that the technique in this case is relatively simple, the doctor must have certain skills. Sometimes the only way that inguinal hernia is treated is surgery. The cost of the procedure is not so high( from 18 000 to 48 000 rubles.), And it is carried out in many hospitals.
Laparoscopy as an alternative to full-scale surgical intervention
Sometimes, as an alternative to traditional surgery, the doctor recommends a procedure called "inguinal hernia laparoscopy".The technique of carrying out such manipulation is significantly different. This is a closed operation, which is carried out with the help of special equipment. Removal of a hernia occurs through three small punctures in the skin. After that, plastic tissue is also carried out with the installation of a special reinforcing mesh, which helps prevent the development of relapse in the future.
Inguinal hernia laparoscopy has its advantages. In particular, this procedure is less traumatic, and the rehabilitation period is much easier for the child. On the other hand, this kind of operation is not possible in all cases. For example, it can not be administered with a bilateral hernia. Since laparoscopy requires special equipment, its cost is higher, and it is much harder to find a clinic offering this service.
Is follicular inguinal hernia possible?
As already mentioned, modern medicine offers several ways to eliminate such a problem as a hernia of the inguinal in children. Operation, plastic, wearing a bandage - all this helps to cope with the pathology and avoid unpleasant consequences in the future. Nevertheless, some parents are interested in the question of what means traditional medicine offers and whether it is expedient to use them.
Immediately it is worth noting that home remedies can in no case be used when infringement of hernia or other complications. On the other hand, in the early stages of the development of the disease, you can try some recipes from traditional healers. For example, daily compresses of freshly prepared wormwood decoction are considered effective.
Sometimes healers recommend making compresses from pickle brine or applying her leaves to hernia. In addition, you can take decoctions from the leaves of bones, gooseberries, bark of larch, infusion of flowers from a cornflower. Once again it is worth recalling that these funds can not replace full-value therapy, and they can be used to treat a child only with the permission of a doctor.