Unfortunately, in modern pediatrics, an inguinal hernia in children is often diagnosed . Surgery is sometimes the only possible treatment. Of course, this pathology causes great concern among parents. That is why many are interested in questions about what a hernia is and what are the mechanisms of its formation. How dangerous can an illness be and what treatment methods does modern medicine offer? What are the causes of the development of pathology and what external signs are it accompanied by? 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. An inguinal hernia is a protrusion of the contents of the abdominal cavity outward through the inguinal canal. Internal organs, such as a loop of the small intestine, ovaries, omentum, bulge through the muscles of the abdominal wall.
It is worth saying that such a pathology is more often diagnosed in male newborns, and premature babies belong to the high-risk group. In most cases, a hernia can be diagnosed quite quickly - it looks like a slight swelling in the groin area, and the hernial sac becomes more noticeable in an upright position. A hernia is treatable, 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 why their child has a hernia. The reasons can actually be very different. Here is a list of the most common risk factors:
- Quite often, the cause is the underdevelopment of the abdominal wall.
- Risk factors include physical stress. Naturally, when it comes to a child, then stress is not associated with physical activity or weight lifting. If the abdominal wall is weak, protrusion of the abdominal organs may result from severe coughing or vomiting.
- Sometimes a hernia is the result of an injury to the abdominal wall, including the period of fetal development.
- This pathology may be the result of overweight in a child.
Pathogenesis of the disease
As already mentioned, a hernia is more often diagnosed in boys, which is associated with the features of anatomical development. Initially, the testes of the fetus are located in the area of the kidneys. Closer to delivery, they descend into the scrotum, dragging along part of the peritoneum. Thus, a kind of pocket is formed in the scrotum, the basis of which is connective tissue. Normally, the pocket overgrows at the time of birth. But sometimes for one reason or another this does not happen. The presence of a pocket increases the likelihood of protrusion of the 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 the girls, their pathology is usually associated with weakness of the connective tissue, as well as physical stress. It is worth noting that a hernia can be congenital or start developing after the birth of a baby. Bulges can appear both on one (more often on the right), and on both sides. Sometimes a postoperative inguinal hernia is diagnosed in children, although in fact, relapses with the correct procedure are minimal.
What are the symptoms of the disease?
Saz is worth noting that the signs directly depend on the degree of protrusion. As a rule, a hernia is a small, oval, sometimes triangular-shaped sac, located either above the pubis or on the outside of the pubic bone. The bulge, as a rule, becomes more noticeable in an upright position. The hernia increases with an increase in intra-abdominal pressure, which is observed, for example, during a scream or cry.
Sometimes it causes severe paroxysmal pain. Soreness makes the child restless, he often cries, sleeps poorly. Symptoms include nausea, loss of appetite, and vomiting.
If we are talking about boys, then an inguinal hernia is able to move towards the scrotum (it is called oblique hernia). In such cases, an enlargement of the scrotum, swelling in the perineum can be observed.
Now you know how inguinal hernia is determined in children. Operation is not necessary in all cases. Nevertheless, if you notice disturbing symptoms, then the baby should immediately show the surgeon. The sooner a diagnosis is made and treatment is started, the less likely it is to develop complications.
Complications arising from a hernia
In fact, inguinal hernia is a serious 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 circulation is possible, which entails a delay or improper development of organs. In boys, the result of a hernia can be pathologies of the reproductive system.
Nevertheless, the most dangerous complication of inguinal hernia is its infringement. A similar situation is associated with pinching of tissues and impaired normal circulation in a particular organ. In turn, this situation is fraught with tissue necrosis, inflammation, blood poisoning, etc.
Infringement and its symptoms
Hemorrhage is a critical situation, especially when it comes to a small child. In such cases, surgery is simply necessary. An infringement of the hernia can provoke an increase in abdominal pressure, which, for example, is observed with strong screaming and crying, physical exertion, coughing, vomiting, etc.
Determining the presence of infringement is quite simple. The hernial sac becomes more convex and hard to the touch. Palpation causes soreness. The child becomes restless, often cries, screams. Often the skin around the hernia acquires a reddish tint. Along with this, systemic signs appear, in particular, an increase in body temperature, fatigue, loss of appetite, vomiting, drowsiness, irritability. If you notice such symptoms in your baby, you need to immediately take him to the hospital, as the lack of qualified help can lead to massive necrosis, pain shock, etc.
Modern diagnostic methods
It is possible to suspect the presence of pathology during a general examination. The hernial sac becomes visible in an upright position, as well as during coughing, crying, etc. During palpation, the doctor may feel a soft elastic formation. By the way, sometimes a hernia can be corrected - put the internal organs back inside. Naturally, the procedure should be carried out by a specialist, and not all bulges are susceptible to such manipulation. If part of the intestine is contained inside the bag, a characteristic rumbling sound can be heard.
In the future, as a rule, an ultrasound examination of the abdominal cavity or pelvic organs is performed (in girls). Only after this, the doctor can decide whether a hernia surgery is needed.
In the event that the specialist decided to undergo surgery, a more detailed medical examination is required, which includes general blood and urine tests, an ESR test and blood coagulation. Sometimes, irrigography is additionally carried out - an X-ray examination of the intestine with a special contrast agent. As a rule, barium suspension is used as a contrast. The procedure allows you to determine the presence of pathologies or abnormalities in the development of the large intestine.
Are there effective conservative treatments?
It is immediately worth saying that conservative therapy is possible only in those cases if the 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 inguinal bandage. It is put on after the hernia has been repaired. This device supports the abdominal wall and keeps the internal organs from protruding. As a rule, an inguinal bandage is worn in the daytime. Nevertheless, it can be left at night if the child, for example, suffers from a night cough.
The bandage is not an alternative to surgical intervention, but only a temporary measure. A small patient is also prescribed regular massage and special therapeutic exercises. These procedures are aimed at strengthening the abdominal wall. Even if therapy gives a positive result, the condition of the child must be carefully monitored, since there is a high probability of developing a relapse in the first 4 years of life.
Inguinal hernia in children: surgery
Sometimes, surgical intervention with such a pathology just can not do. This procedure, as a rule, is carried out at the age of 6-12 months. Its essence is quite simple. Using special tools, the doctor disconnects the hernial sac and the abdominal cavity. In this case, it is necessary to ensure that the internal organs remain in place. Surgery is performed under general anesthesia and lasts about 30 minutes. This is what an inguinal hernia operation looks like . Reviews indicate 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 an 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-blown surgery
Sometimes, as an alternative to traditional surgery, the doctor recommends a procedure called “inguinal hernia laparoscopy”. The technique for carrying out such manipulations is significantly different. This is a closed operation, which is carried out using special equipment. The hernia is removed through three small punctures in the skin. After this, tissue plastic is also performed 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 tolerated by the child much easier. On the other hand, this kind of operation is far from possible in all cases. For example, it cannot be prescribed for bilateral hernia. Since laparoscopy requires special equipment, its cost is higher, and finding a clinic offering this service is much harder.
Is alternative treatment for inguinal hernia possible?
As already mentioned, modern medicine offers several ways to eliminate such a problem as inguinal hernia in children. Surgery, plastic surgery, 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 remedies traditional medicine offers and whether it is advisable to use them.
Immediately it is worth noting that home remedies can in no case be used for infringement of a hernia or the presence of 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 from a freshly prepared wormwood decoction are considered effective.
Sometimes doctors recommend making compresses from pickled cabbage brine or applying sheets to a hernia. In addition, you can take decoctions from the leaves of bone, gooseberry, larch bark, infusion of cornflower flowers. Once again, it is worth recalling that these funds cannot replace full-fledged therapy, and they can be used to treat a child only with the permission of a doctor.