Umbilical hernia in children 3 years of age is common. True, pathology is especially common in the first year of life. However, in older children, this phenomenon takes place.
A navel hernia is a protrusion of internal organs from the abdominal cavity through the umbilical opening. During pregnancy, the umbilical cord creates a close relationship between a woman and a child, provides him with nutrition, delivers oxygen and all the useful substances necessary for development. When a child is born, his own pulmonary breathing opens, which gives him the opportunity to take food orally. From this moment, the biological need of the child for the umbilical cord disappears.
An unnecessary umbilical cord after birth is cut in the delivery room. An umbilical cord remains inside the baby’s abdomen, which eventually overgrows with connective tissue. This occurs on average by the end of the first month of a child’s life. By the end of the neonatal period, the navel must finally heal.
How to practice?
However, this is a standard course of events, but in practice everything happens differently. Sometimes it happens that the cord does not overgrow completely, since the connective tissue forms too slowly. This is what provokes the development of a hernia in the navel. A hernia can occur due to malformations in the development of the walls of the peritoneum, as well as as a result of improper actions by obstetricians. According to statistics, every third baby born prematurely suffers from a hernia in the navel. Before school, only 4% of children have a hernia.
Varieties
Navel hernias are divided into two main types - acquired and congenital. Doctors suggest that in the case of a congenital hernia, the problem started even before the baby was born. Experts believe that the hernia appeared as a consequence of the pathology of fetal development.
Acquired umbilical hernias in children of 3 years, in turn, are divided into oblique and straight. The latter arise as a result of changes in the fascia of the umbilical space. This provokes the exit of the hernia through the umbilical ring. In the case of oblique hernia, the umbilical nodule is formed not in the navel itself, but next to it. The most frequent localization of oblique hernia is between the thinned wall of the peritoneum and the transverse fascia, as well as the white line of the abdomen. After passing this path, a hernial sac forms in the umbilical ring.
In addition, conditionally hernias can be divided into those that are repaired and those that are not amenable to mechanical stress. The latter often cause infringement of the hernial sac and acute pain.
Causes
According to most experts, children born with umbilical hernia (code according to ICD-10 - K42) were exposed to pathogenic intrauterine exposure. The cause of the appearance of a congenital hernia may be a violation in the formation of the peritoneum at the cell level. A similar reaction can occur with hypoxia, as well as with a number of genetically caused diseases.
Newborns are diagnosed in a situation where the umbilical ring heals too slowly. Risk factors for newborns are:
1. Loud and frequent crying.
2. Regular constipation.
3. Increased gas formation.
4. Weakness of the umbilical ring of a hereditary nature.
5. Respiratory diseases in acute and chronic form, accompanied by severe cough.
Weight lifting
Umbilical hernia in children 3 years old can form against the background of lifting weights and weak abdominal muscles. Quite often, parents independently provoke the appearance of hernias, putting the child on the legs too early and putting the children in walkers and jumpers. The child’s muscles are not ready for the load in an upright position. He should begin to crawl, thereby strengthening his stomach and back, and then get up. In case of violation of the sequence prescribed by nature, after a year the child has an umbilical hernia.
Over the age of three years, the appearance of an umbilical hernia (code according to ICD-10 - K42) can provoke excess body weight and scars left on the abdomen after surgery. A prolonged and intense cough also increases the likelihood of a hernia, regardless of the age of the child. Another factor provoking the appearance of an umbilical hernia is excessive stress after a long break.
Symptoms of umbilical hernia in children
The navel sticks out in almost all infants to one degree or another. However, a hernia strongly protruding or even protruding the navel of an infant cannot be called. Umbilical hernia in children 3 years old is characterized by a certain set of symptoms and signs, this pathology has its own specific clinical picture, in which the protruding navel is not a key indicator.
Severe pathologies with the development of the peritoneum, when the hernial sacs are large enough to exit several organs at once, such as the intestines and liver, are diagnosed even during the period of gestation. During a planned ultrasound examination, a specialist should pay attention to a similar pathological process. The fetus in this case is considered unviable and rarely lives more than three days after birth, even under intensive care. Most often, umbilical hernia in this case is due to a genetic factor.
What does umbilical hernia look like? The hernias acquired after the birth of the baby rarely give the baby discomfort. As a rule, the hernial nodule does not exceed 5 centimeters and tends to appear when the child strains the abdominal muscles. In a calm and relaxed position, the hernia leaves.
First sign
The first sign of an umbilical hernia is a swelling in the area of the cavity in which the navel is located. At the initial stage, it is easily adjusted with a finger, but later spikes appear and difficulties arise with the adjustment. Some parents write off intestinal colic, poor sleep and constipation on an umbilical hernia, but experts do not confirm this opinion. Sometimes a child’s stomach hurts at 3 years old, and this may indicate the presence of a hernia.
Pathology does not affect the digestive process, so the nausea often attributed to this pathology is most likely caused by other factors, for example, overfeeding the child. Another thing, if it came to pinching a hernial sac. This is an emergency and requires urgent action. Fortunately, infringement of an umbilical hernia, in contrast to an inguinal hernia, is quite rare. Symptoms of umbilical hernia in children should not go unnoticed.
In most cases, acquired pathology in children goes away by the year by itself. This is due to the strengthening of the abdominal muscles. If the hernia was acquired by a child after three years, it is necessary to conduct a thorough examination and choose a treatment method, most often surgical. At the age of over three years, an umbilical hernia is accompanied by mild nausea and constipation. Drug treatment in this case is ineffective, and the result of physiotherapeutic procedures is doubtful.
What an umbilical hernia looks like, every parent should know. This will help to avoid complications.
Danger of Infringement
The presence of a hernia in the umbilical or umbilical space is dangerous only in case of infringement of the internal organs that fall into the hernial sac. The most common cases of pinching of the intestinal ring. In young children, this probability is rather small, but in an older child, the risk of infringement increases.
The main signs that an infringement has occurred are considered:
1. Often a child has a stomachache of 3 years. The pain is characterized as acute and sudden, of a high degree of intensity, spreading to the entire abdomen.
2. Nausea and frequent urge to vomit.
3. The feeling of fullness of the abdomen, difficulty in the passage of gases or their complete absence.
4. In the feces there is an admixture of blood.
5. The hernial sac becomes inflated, darker and more tense. When in a horizontal position, the hernia does not go away.
Infringement occurs against the background of very narrow hernial gates. If the gates are wide, infringement is unlikely. The signs listed above cannot be ignored. The child with the first symptoms of infringement must be laid to one side and call an ambulance. With this pathology, the child is placed in the surgical department.
In newborns, in most cases, hernias are repaired independently, but more complex cases are not excluded. It is important to visit a pediatric surgeon and observe the course of pathology, receive specialist recommendations and follow them. Do not be inactive if a child has an umbilical hernia. It is better to get qualified medical care.
During infringement, the child should not be given a lot of water, pain medication, or a cold or hot compress. Also prohibited is the independent reduction of a hernia. This can lead to peritonitis and necrotic process in the internal organs.
Diagnostics
If a child has an umbilical hernia, what should I do? This question is often asked by the parents of the kids. A pediatric surgeon can determine the presence of pathology. If parents suspect an umbilical hernia, it is worth starting with this specialist. The surgeon will conduct a visual examination and palpation of the abdomen of the child, get acquainted with the anamnesis, and also ask some questions about the course of pregnancy and childbirth. The surgeon will also be interested in the healing process of the umbilical wound.
Sometimes the doctor asks the child to cough (if age permits). This is part of the initial examination of the child for the presence of umbilical hernia. A qualified specialist will determine a hernia even on the basis of palpation, however, to clarify the diagnosis, a number of additional examinations will need to be done.
Research methods
The list includes ultrasound examination of the abdominal cavity, allowing you to confirm the presence of a hernia, its size and exact location. In addition, radiography and irrigoscopy may be needed. The last study is carried out after the introduction of a contrast medium into the intestine. This method allows you to visualize all parts of the intestine and identify the presence of adhesions, defects and perforations. In some cases, the child is prescribed endoscopy. The examination also includes blood and urine sampling for a general study.
How to treat an umbilical hernia will be described below.
Treatment
The main and most effective method for treating umbilical hernia today is surgery. However, in childhood this causes certain difficulties. As a rule, surgery in the newborn is performed only in emergency cases, since a hernia has the property of regressing. An emergency case is an infringement of an umbilical hernia. Therefore, most often, doctors prescribe wait-and-see tactics. If the hernia does not go away on its own by five years, a planned operation is performed.
Indications for surgical removal of umbilical hernia in children are over five years of age, as well as a bulge of more than 1.5 cm.The decision to perform an operation is made if the hernia is prone to growth, as well as in the presence of narrow hernia gates. The official name of the operation is hernioplasty. During the manipulation, the hernia sac is excised, which is replaced by its own tissue or a special mesh implant, which takes all the burden on itself and does not allow the hernia to recur.
How to treat an umbilical hernia, the doctor should prompt. In childhood, it is considered optimal to use the method of tension-free hernioplasty when an implant is used. Excision of a hernia is not performed in every case. Sometimes it is possible to correct the formation and fix it in such a way as to prevent further protrusion, that is, the need for its removal, in fact, is not.
The mesh implant is installed both directly above and below the umbilical ring. It depends on how wide the hernia gate is. At the final stage of the operation, the hernia is sutured to prevent relapse. Modern medicine allows surgery on an uncomplicated hernia with a laparoscopic method. This is a minimally invasive intervention with a minimal traumatic effect and a quick recovery period. In addition, the reduction and excision of hernial sacs is carried out using more modern methods, for example, using a laser.
Surgical intervention is performed under any type of anesthesia, which is important in relation to the treatment of small patients. However, not all surgical hospitals perform such operations in childhood. Quite a lot of specialists adhere to the tension method when removing a hernia. The question of the method of the operation is discussed at the preparatory stage with the surgeon.
A modern development that helps to cope with umbilical hernia is the umbilical patch Porofiks. A medical device is also recommended to be used as a prophylaxis of pathology.
Rehabilitation
If the child underwent an operation to remove a hernia by the tension method, without using an implant, the recovery period can last from a month to six months. Under the ban during this period will be physical activity. The risk of repeated protrusion of the hernia is rather high. A lightweight method of hernioplasty does not require such a long rehabilitation. After a few weeks, any restrictions on the child are removed, and he can continue to lead a full-fledged lifestyle. Moreover, the probability of relapse after surgery according to this method is less than one percent.
It is important to monitor the correct diet of the child in the recovery period after umbilical hernia surgery in children. The therapeutic diet is aimed at minimizing gas formation. Peas, cabbage, kefir and carbonated drinks are excluded from the diet. With constipation, the child is allowed to take soft laxatives. Enema can not be done, as well as allowing the child to overstrain during the act of defecation.
Do not give children too thick or too hard food after surgery. It is advisable to include various liquid cereals, compotes and jelly in the diet. Only after one week after surgery can the child's diet be expanded. This should be done gradually. Another condition for successful rehabilitation is the wearing of a special postoperative children's umbilical hernia band, as well as therapeutic exercises and massage. In the future, you can connect an older child to sports, as this will strengthen the abdominal muscles and avoid relapse.