Inguinal hernia in a baby boy is a fairly common pathology. In 90% of patients, it is congenital and is due to the peculiarities of intrauterine development. But it should be noted that it can develop in older children, and in this case, the following factors provoke its appearance:
- weak muscles of the inguinal canal;
- excessive physical activity;
- diseases manifested by severe coughing, constipation or vomiting;
- abdominal injuries.
In more detail about how to recognize an inguinal hernia in children, how it manifests itself and how it is treated, we will describe later in the article.
Hernia structure
Many are interested in what is an inguinal hernia in boys. The photo below shows a schematic representation of the structure of this formation. In all hernias, it is similar, regardless of the reasons for the appearance and location.
In their structure, doctors distinguish:
- Hernia gate. This is the very hole through which, in fact, the loss of entrails occurs.
- Bag. It is a connective tissue and fatty tissue that surrounds the organs that have fallen into the hernia gate.
- Hernial contents. In the presence of a pathology of interest to us, it is usually represented by a loop of the intestine, part of the bladder, omentum, and in some patients even by the appendix.
Outside, an inguinal hernia in boys looks like a rounded protrusion, which noticeably increases with any tension of the abdominal muscles - crying, laughing, coughing, etc. In older children, it becomes noticeable during running or walking, almost disappearing at rest.
Hernia classification
As already mentioned, inguinal hernia in children (boys), the symptoms and treatment of which we will consider later, is divided into congenital and acquired. By the way, the dropsy of the testicle or spermatic cord, as well as the cyst of the latter, often join the last type of pathology.
According to the structural features of the hernia, they are divided into straight, oblique and combined. Moreover, the latter case is characterized by the appearance of several protrusions, which, as a rule, are not interconnected.
In addition, distinguish between unilateral and bilateral hernia. The first most often develops on the right side, but the second is a rather rare occurrence.
Causes of inguinal hernia
In medicine, a clear connection between the occurrence of inguinal hernia in newborn boys and the lowering of the testicle is determined. The fact is that in the fetus this paired organ is located where it began to lay, namely in the lumbar region.
In an unborn baby, after the sixth month of fetal development, the testicles descend in turn through the so-called inguinal canal to take their place. And along the way, in some cases, they carry along a portion of the peritoneum - a thin film lining the abdominal cavity. This usually happens with the right testicle, which drops last. For a while, all this looks like an open pocket, but by the time of birth, usually the testes are already located in the scrotum, and the "pocket" is closed.
Unfortunately, this does not always happen, and in such cases they talk about the presence of oblique inguinal hernia in boys. Its name is associated with the peculiarity of the location. There is also an option for a direct scrotal hernia, which develops as a result of strong physical exertion or increased pressure in the abdomen. In this case, it passes, without affecting the inguinal canal, through the wall of the abdomen.
Symptoms of inguinal hernia
It should be noted that signs of an inguinal hernia in boys are not always obvious. It may not cause obvious discomfort in the crumbs and manifest itself only in the form of a slight protrusion of a round or oval shape, which is easy to detect upon examination.
At the same time, it can disappear in a lying child, and in a standing position - reappear. In order to timely detect the existing pathology, parents need to carefully observe the baby at the moment when he coughs, sneezes or otherwise strains the tummy. At such moments, the protrusion, as a rule, becomes apparent.
Older children may complain of pulling pain or a feeling of pressure in the protruding area. They often have rumbling of the intestines. In some cases, there is a tendency to constipation, nausea and urination disorders.
Symptoms of crushing of an inguinal hernia
The main danger of the described pathology is that in case of its known complication - pinching - the organs that are in the hernial sac will be pinched, which can lead to serious consequences.
As a rule, the symptoms that appear when an inguinal hernia is pinched in boys are difficult to confuse with something. The child suffers from severe pain (in some cases, even pain shock may develop), he has a fever, vomiting may begin.
In the presence of the listed signs of the baby, it is necessary to urgently be hospitalized, since procrastination threatens the development of necrosis of restrained tissues and the development of diffuse peritonitis caused by the transition to the peritoneum of the inflammatory process.
Other complications
Inguinal hernia in boys can cause other, no less serious complications:
- Its presence can provoke the development of appendicitis. This occurs in those rare cases when the appendix falls into the cavity. A similar situation leads to circulatory disorders in the named organ, which, in turn, causes the development of the inflammatory process and general intoxication of the body. High in this case, and the risk of rupture of the appendix.
- If the hernia reaches a large size, then its contents can no longer independently become out of place. This condition is called the herniation of the hernia and causes the boy great discomfort.
- It is extremely rare, but nevertheless, in children against the background of inguinal hernia, intestinal obstruction can also develop. It provokes a combination of the described pathology with an existing violation of peristalsis. This is expressed by pain, lack of stool, nausea, violation of gas exhaustion, loss of appetite.
In each of these cases, you must immediately seek medical help, as they can lead to serious consequences for the child.
Inguinal hernia in boys: treatment of children
Diagnosis of this disease is carried out using a conventional visual examination of the child, as well as ultrasound and radiography. Additionally, general blood and urine tests are prescribed.
Treatment in boys of an inguinal hernia, not prone to infringement, can be carried out using conservative methods. In this case, it is aimed at strengthening the abdominal muscles with the help of massage, therapeutic exercises and swimming. The child is also prescribed to wear a special bandage, necessary to prevent possible complications.
Drug treatment of the described pathology does not exist. Medications are used only when a pain syndrome occurs, the development of the inflammatory process or other manifestations.
First aid for infringement of an inguinal hernia
Inguinal hernia in children (boys), as already mentioned, can be infringed, which can lead to serious complications. Therefore, parents should be very attentive to the condition of the child. It is important to be able to provide him first aid, since children's elasticity of blood vessels and better than in an adult patient, blood supply to the intestinal loops allows the restrained hernia to recover on its own.
In the first hours after the infringement of the child is found, it is important to calm and place him in a warm bathroom for 15-20 minutes. In this case, he should be given antispasmodic drugs that relax muscle tissue. After this, the boy should be put on his back, with a basin raised with a pillow. Do not try to force a restrained hernia!
If all these measures after 1.5-2 hours did not lead to the desired result, the child is shown urgent surgical intervention.
Surgical intervention in the treatment of inguinal hernia
With infringement, the only way to treat an inguinal hernia in a boy is surgery. It is aimed primarily at eliminating the consequences of the infringement, since by the time of the surgery the loop of the intestine or part of the omentum, which are in the hernial sac, may already be dead. In this case, they are excised.
The planned operation is carried out, as a rule, in the conditions of a day hospital, which means that the child can go home on the same day. Refuse it only with serious contraindications. These include a lag in the body weight of the child, a young age (less than six months), the presence of infectious diseases or rickets.
Hernioplasty is most commonly used. This is a simple procedure, involving the removal of the contents of the hernial sac and removal of the latter. As a rule, it lasts no more than 30 minutes and is carried out under general anesthesia. It is done in two ways:
- Through an open cavity. For this, the abdominal wall is dissected in the protrusion region. And the pathological opening is closed either by laying muscle tissue on top of each other, or with the help of mesh implants.
- The closed method is laparoscopy. During the operation, the surgeon makes a puncture through which the equipment necessary for manipulations is introduced. This method is considered the safest, does not leave scars and does not cause side effects.
If the patient did not have self-absorbable, but traditional sutures on the surgical wound, they will be removed in about a week. Thanks to modern technology, an operation to remove an inguinal hernia is as safe and painless as possible for a child.
Can the operation cause complications
Surgical intervention in the treatment of inguinal hernia in children (boys) rarely causes serious complications. Relapses are observed in no more than 1% of cases, and they are most likely in the first six months after the operation. As a rule, this problem is faced by premature babies, as well as suffering from pathologies of connective tissue.
Most often, patients have suppuration or divergence of the suture, as well as the formation of hematomas in the affected area. In some cases, the child may develop an inflammatory process of the testicle, its high fixation or accumulation in the membranes of the lymphatic tissue. Rarely, violations of surgical intervention lead to the development of infertility.
To prevent such manifestations, the boy after the operation should be under the supervision of a specialist.
Postoperative period
Children, as a rule, tolerate the described operations well. Wound care consists in dressing it and treating it with antiseptics. She may get wet the first five days after surgery, but with a clear tendency to improve.
With severe pain in the first time after surgery, the patient may be prescribed a painkiller. And in case of complications, antibiotics are used, as well as drugs that strengthen blood vessels and enhance the immunity of the child.
To avoid complications, parents need to adhere to the following recommendations:
- From the boy’s diet, foods that provoke increased gas production and the development of constipation should be excluded. It is important to provide the child with good nutrition.
- If you continue to breast-feed your baby, then you will have to take care of changes in your diet.
- Save your child from physical exertion. Do not let him cry for a long time or loud laughter.
- Pick up with your doctor and perform a set of exercises daily aimed at strengthening the muscles of the abdominal cavity.
Prevention
Since most often in boys there is a congenital variety of the described disease, timely and regular examination of the baby by a specialist can be considered measures to prevent its development.
Prevention of acquired inguinal hernia in boys can be carried out by strengthening muscles, eliminating excessive loads, treating chronic cough, regulating bowel function, ridding a child of constipation and obesity.