What causes inguinal hernia in children. Inguinal hernia in a child: causes, symptoms, treatment methods and possible complications

The peculiarity of hernioplasty lies in the fact that it is important for the surgeon to assess the viability of the hernia contents before the start of surgery. If the organs in the infringement were dead, during the operation the doctor resects them. Hernioplasty is performed on an outpatient basis, the patient's recovery lasts several hours, after which he will be discharged.

The result of an inguinal hernia operation in children is the restoration of the anatomical structure of organs, blood circulation in the small pelvis, the elimination of inflammation and the risks of developing serious complications. Lethal outcomes in surgical intervention of this type are observed in 0.5% of cases.

Prevention

emergence congenital pathologies very difficult to predict because external factors may not be specific to a particular disease.

Doctors advise parents of newborn babies to regularly undergo surgical examinations for a predisposition to protrusion of internal organs.

It is also important to look after the child's health: perform a muscle-strengthening massage, prevent or treat intestinal disorders, monitor the normal functioning of the intestines, and do not expose the baby to heavy physical labor.

Inguinal hernia, which often manifests itself already in the first year of life, requires timely response from parents, consultation with a surgeon and proper treatment.

If the disease is at the initial stage, then you can do without surgery, but only surgery can cure the advanced form. At an early age, surgery will be quick and without complications. According to statistics, pathology is diagnosed in girls less often than in boys.

An inguinal hernia is a pathology that provokes a protrusion of the internal organs of the peritoneum under skin through natural openings located in the groin. There are many or one protrusion in children. Most common cause this - fine structures anterior abdominal wall, congenital or acquired factors.

In boys, the presence of a hernia is noticeable if, while walking, he feels discomfort and soreness, swelling appears in the groin.

If a baby has this ailment, you need to know what to do in such a situation:

• agree to surgery to prevent complications;
• the disease is dangerous to health, because at any moment pinching can occur;
• in case of infringement, hospitalization is urgently needed;
• emergency intervention increases the risk of recurrence.

The congenital form in children is oblique. With this form, the logans, following the ring, fall into the groin. Direct hernia is the rarest phenomenon, it is characterized by an exit through a defect in the muscle of the external inguinal ring. A hernia can be localized on one of the sides - on the right or on the left, or on both sides at once.

In boys in infancy, the pathology is found on the right side (60%). A little less often (30%) from the left, and only in some patients it is localized on both sides of the groin. Doctors also classify inguinal and inguinal-scrotal hernias.

Causes of inguinal hernia in children

During the period of fetal growth inside the womb, together with all other organs, a special channel is formed, which begins to go from the peritoneum towards the groin. At this moment, conditions are formed that will help parts of the organs move to the position they need.

It is due to the special conditions of development that the disease affects the male body. But in female babies main reason manifestations of the disease is the improper maturation of the round ligament of the uterus.

But not only abnormal development inside the womb provokes the development of the disease, there are also a number of other factors:

• overweight;
• underdevelopment of the muscles of the abdominal wall;
• permanent loads;
• peritoneal injury.

Inguinal hernia in children (boys) appears due to the fact that developmental anomalies occurred in the womb. The surgeon can diagnose the disease already in the first hours after birth. At a certain time, already mature testicles are located close to the kidneys. When the baby is born, they are sent to the scrotum through a special channel, at the same time they take away part of the peritoneum.

After that, a pocket gradually begins to form - the vaginal process, which should be completely overgrown until the moment of birth. In the case when this process does not grow, the organs of the peritoneum may fall out into the lumen. As for girls, they rarely have a congenital form of the disease, because they do not have such a process. The acquired form is diagnosed quite rarely.

After birth, a hernial sac is rarely formed. Most often, the diagnosis is made to adolescents of the stronger sex.

There may be several reasons for the development of this disease:

• surgery on the scrotum or internal organs, carried out in early childhood;
• peritoneal tissues are developed incorrectly;
• excessive loads - a sport that includes weight lifting.

It is possible to visually identify a protrusion in the groin, but it is extremely difficult to cure it without surgery.

Symptoms of inguinal hernia in children

Inguinal hernia in children (boys) in the first days after birth and a little older manifests itself in the form of a slight swelling of the skin, localized in the groin. Puffiness in the scrotum can also tell about its presence. Often notice the swelling is noticeable only at the moment when the baby coughs or cries.

That is why adults often believe that whims are associated with a hernia, but the disease appears in infants due to crying, but there are many reasons for this. Girls are less likely to be diagnosed with the disease. In them, the disease happens if a loop of intestines or ovaries push the abdominal wall into the groin, sometimes it can reach the labia majora. This protrusion on the body resembles an oblong cord.

If, after the birth of a girl, swelling of the labia is clearly visible, then this may be triggered by excess fluid or an increased level of hormones received from the mother immediately before birth. This swelling will not harm the baby, he goes off without help in a few days.

Inguinal hernia in children (boys and girls) often causes pain in the groin and abdomen. It can give to the sacrum or lower back. It is these symptoms that often cause crying and whims in the first year of life. But older children tell adults about the pain that occurs in the lower abdomen.

Common signs of a hernia:

• loss of appetite;
• vomiting and nausea;
• insomnia;
• diarrhea or constipation;
• discomfort during urination;
• pale skin;
• general weakness and malaise.

Such symptoms should force parents to call an ambulance and consult a pediatrician in order to prevent complications.

Diagnosis of inguinal hernia in children

You can independently identify an inguinal hernia by examining your child. Or the pediatrician does it during a routine examination of the baby. By palpation, it is possible to identify how elastically it protrudes and whether its structure is soft. If complications are not observed, then the contents of the hernia are easily reduced into the peritoneum.

During this procedure, it is possible to hear a characteristic rumbling, indicating that an intestinal loop has entered the hernial sac. When the reduction has already been carried out, it is possible to feel the inguinal ring with an expanded entrance.

To accurately diagnose, the pediatrician may prescribe a number of additional studies:

• Ultrasound of the abdominal cavity, pelvic organs, inguinal canals and scrotum. With its help, it is possible to determine the contents of the hernial sac, what exactly is the liquid or intestinal loop in it, as well as the place of its localization. On ultrasound of the small pelvis in girls, it is possible to identify the features of the hernia and the place of its localization.
• Irrigography makes it possible to determine whether there is a protrusion, as well as obstruction in the intestine. The essence of the technique is to conduct an x-ray of the colon. The procedure is carried out after emptying the intestines, filling it with a special contrast agent.
• Cystography.

Inguinal hernia in children (boys) requires the surgeon to conduct differentiated diagnostic measures for certain diseases:

• inguinal lymphadenitis;
• hip hernia;
• cryptorchidism, found in male children;
• cyst of the round ligament of the genital female organ;
• cyst of the spermatic cord and dropsy of the testicle in boys.

Only after an examination and an accurate diagnosis is the best therapeutic technique selected to help remove the disease without recurrence.

Prevention of inguinal hernia in children

Watch your weight, you can not gain it and lose it quickly. It is necessary to prevent heavy lifting, severe overvoltage, excessive loads, and also not to injure the abdominal wall.

Treat in a timely manner ailments that can lead to increased pressure in the peritoneum:

• respiratory pathology;
• colds;
• constipation;
• problems with urination.

Women, bearing a baby, should monitor the work of the intestines, avoiding constipation. Exercise, but don't overdo it. For newborns, for preventive purposes, it is important to properly tie the umbilical cord. Young parents need to learn how to feed the baby properly, make sure that he does not overeat.

Babies should be placed on the stomach as often as possible to strengthen the muscles of the peritoneum. The baby should not be tightly swaddled, put early in a horizontal position and tossed up.

Treatment methods for inguinal hernia in children

If even a slight swelling in the groin area was found, the first thing to do is to consult a surgeon. The only method that will completely get rid of the disease is surgery. Planned intervention is carried out as soon as possible.

The term for each baby is individual. But as practice shows, the surgeon performs it immediately after the diagnosis. But if the hernia is freely reduced, then surgery can be postponed, wait until the baby is at least 6 months old.

But you need to remember that the baby must be under the close supervision of adults and especially the surgeon, so that in case the situation worsens, an emergency operation can be performed.

Surgical intervention

Before performing surgery, a small patient must be prepared. The safety of the baby depends first of all on the activities. Before removing the hernia, the surgeon must carefully examine the child and assess his health. First of all, at the time of getting into surgery, he should not have concomitant diseases, for example, a cold.

Therefore, the child must be examined by a pediatrician who can prescribe a number of procedures:

• pass general analysis blood;
• Analysis of urine;
• undergo an examination to detect infectious diseases;
• coagulogram.

Also, the baby must be examined by an anesthesiologist who can accurately select anesthesia. The operation is performed under general anesthesia. The main goal of the surgeon is to remove the inguinal hernia.

• laparoscopy;
• abdominal intervention.

Laparoscopy is latest technique, which is considered less painful and traumatic. Its main advantage is complete absence traces - no scars and scars. During this procedure, the patient is under general anesthesia and the procedure takes no more than an hour. During the operation, the surgeon makes 3 small incisions in the affected area.

Using a laparoscope, the surgeon displays an image of the internal organs of the peritoneum, examining the formation. Subsequently, with the help of special tools, the hernia is cut off. This type of operation is used only at the initial stage of the disease.

In cases where there is an infringement of nearby organs, it is recommended to carry out open operation. Open surgery can be performed on children from the age of 3 months. The intervention, as a rule, is planned and does not take more than half an hour.

The kid is injected general anesthesia, he falls asleep, and the surgeon, strictly following the protocol of the operation, performs the following manipulations:

1. The surgeon makes an incision with a scalpel in the groin area, its size does not exceed 3 cm. After the operation, there is no trace of the suture.
2. Next, the hernial sac is separated from the tissues adjacent to it, and all internal organs are returned to their place.
3. Next, the hernial sac is removed, and the affected area is bandaged.
4. The incision is closed with intradermal cosmetic sutures.

Recovery after such an operation is quite fast. Parents of a child who has had an inguinal hernia removed need to keep the bandage over the suture clean. It is recommended to change it once a day. If the dressing is performed in a hospital, then you should not ignore the trip to the hospital.

After laparoscopy, a small patient is discharged on the 3rd day. He can move freely, attend a preschool, but it is better to limit physical activity at first.

But after an open intervention in the first 14 days you will have to wear a bandage. Remove it only during sleep. The sutures are removed in the first 7 days after the operation. Postoperative sutures should not be wetted. If there is redness or swelling, then you need to urgently seek help from a surgeon or pediatrician.

Folk ways

If there is an infringement of the hernia, then use a conservative or folk treatment it is forbidden. In this case, there is only one way out - surgery.

But if there is no infringement yet, and the date of the operation has already been set, then in order to wait for it and alleviate the patient's condition, you can use the following folk recipes:

1. Inguinal hernia in children (boys and girls) is treated with a sour cabbage leaf, which is recommended to be applied to the diseased area. The brine in which the cabbage was fermented also helps well. The sheet should be warm, and you can heat it in a water bath, putting it in a colander and supporting it over steam. If it is a brine, then it is slightly warmed up, a piece of tissue is moistened and applied to the place of protrusion of the organs. Carry out the procedure 2 times a day for at least two weeks.
2. A solution of vinegar and water helps. They need to wash the swollen area. Prepare it like this: for 250 ml of water you need 2 tbsp. l. table vinegar. After washing with this solution, a warm compress is made from oak infusion for half an hour. To prepare it, you need to grind acorns and oak bark, put in a container and fill it with red wine, leave for 21 days. Apply to the site of swelling.
3. Poultices based on a decoction of the herb herb. Need to take the leaves medicinal plant, steam and apply to the affected area. The procedure is carried out 2-3 times a day. This method helps to avoid complications.
4. In the treatment of inguinal hernia, it is recommended to drink various infusions from medicinal herbs. They will help strengthen tissues and ligaments. For these purposes, it is often recommended to drink an infusion of cornflower flowers. To prepare a decoction, you need to take 3 tbsp. l. raw materials, pour 1 tbsp. boiling water, leave to insist and drink 1 tbsp. l. 3 times a day. They also drink a decoction of gooseberry leaves or drupes prepared in the same way.
5. A hernia can be treated with a hot infusion prepared using larch bark. For cooking, you need 125 g of bark, pour 2 tbsp. boiling water, leave for 12 hours. Strain and drink once a day for two weeks. Also, this solution is suitable as a compress.

Traditional medicine in the treatment of hernia is only additional remedy but not the main one. They will help the patient to simply wait for the operation and prevent serious complications, but they will not be able to completely cure the disease.

Treatment without surgery

If the child was admitted to the hospital, and after examination the surgeon did not reveal absolute indications for surgical intervention, then in the hospital he is given a set of measures to reduce the hernia. The patient is administered a single dose of Pantopon, which is calculated depending on the age of the child. This is followed by a warm bath.

The water temperature is not more than 38 ° C, the procedure lasts about a quarter of an hour. You can simply put a warm heating pad on the groin area. After carrying out all these procedures, the baby calms down and falls asleep, and after that there is a spontaneous reduction of the hernia. A similar result can be achieved in a third of patients admitted to the hospital.

Conservative therapy lasts no more than an hour. If during this period of time the protrusion does not disappear, the date of the surgical intervention is set, then all manipulations are considered preoperative preparation. If an operation cannot be dispensed with, then preoperative measures are not carried out.

There are several basic methods that allow you to strengthen the muscles of the peritoneum. They will not give a 100% result, so you need to regularly monitor the child.

Main methods:

Complications

According to statistics, after surgical removal of a hernia, recurrence can occur in only 1% of patients. Most often, premature babies and those with poorly developed connective tissue are at risk.

The disease may return if the operation was performed urgently. If the diagnosis is established as early as possible and the surgical intervention is planned, without waiting for any complications, then there will be no serious consequences.

If the operation was performed by an unskilled surgeon, then the following complications may appear in the future:

• infertility;
• high testicular fixation;
• lymphostasis;
• lymphocele.

If you do nothing, then it can happen:

• infringement- internal organs are compressed, and then die;
• peritonitis- the inflammatory process begins due to the fact that the organ is ruptured;
• coptostasis- retention of feces in the loop that got into the hernial sac;
• ischemic orchitis- the testicle becomes inflamed due to the fact that blood circulation is disturbed.

In order to prevent complications, it is urgent to carry out a surgical process that will not harm the baby. An inguinal hernia will not bring any inconvenience to the child if diagnosed and operated on in time.

If children have contraindications for an urgent operation, then conservative treatment methods can be temporarily used, but they will not cure, but only alleviate the condition of boys and girls. Massage, wearing a bandage and reduction will be a good solution, but not for long.

Therefore, at the first opportunity, it is worth performing a surgical intervention and forget about the disease once and for all. A hernia is not a sentence, any surgeon can solve the problem in just 1 hour, and in a few days the child will be able to lead a full life, without limiting himself in anything. But inaction in some cases can even cost the child his life.

Video about inguinal hernia in children, its symptoms and methods of treatment

Treatment of inguinal hernia in children:

Causes and symptoms of inguinal hernia in children:

How treat inguinal hernia in children And in what cases it is possible to do without operation? Today we will talk about what modern treatment inguinal hernia in a child completely eliminates the problem and does not adversely affect the functioning of adjacent organs.
An inguinal hernia is a tumor that has arisen in the groin area. If the formation has spread to the scrotum, the hernia becomes inguinal-scrotal. In this tumor (hernial sac) is the ovary, omental strand, intestinal loop, and other organs. If you press on the hernial sac, you can hear a kind of rumbling, then the formation disappears, reduction occurs.
Often in children diagnosing oblique inguinal hernia. The disease proceeds in the same way as a cyst of the spermatic cord or dropsy of the ovary communicating. The vaginal process of the peritoneum (wide, not overgrown) acts as a hernial sac, which connects abdominal cavity and scrotum. From the abdominal cavity through the process, everything is displayed in the inguinal canal. Inguinal hernia in children- a fairly common disease in our time and in most cases is indicated hernial sac removal surgery to avoid the destruction of the structure of the inguinal canal under the pressure of a hernia that grows with age.

For a child, an inguinal hernia is a serious ailment that needs to be treated. The use of recipes from traditional medicine in most cases exacerbates the problem. In babies, hernias are predominantly congenital, arising from weak muscle tissue in the anterior part of the peritoneum. Doctors notice them immediately after the baby is born. Sometimes muscle weakness is due to the prematurity of the baby, not all organs are sufficiently developed in him.

When an inguinal hernia is found in a child You should immediately consult with your pediatrician. After the examination, he will explain how to deal with the disease in a particular case.
Inguinal hernia is eliminated with the help of operations, which is performed on a small patient no earlier than six months. When exactly - the pediatric surgeon decides.

But if the inguinal hernia in a child is restrained, then it should be corrected immediately. In the event that this is difficult to implement, an urgent surgical intervention is indicated (within 6 hours from the moment of infringement).

Herniotomy is done to the baby on the day he went to the hospital. During the operation, the surgeon removes (sutures) the hernial sac, sets the displaced organs, returning the normal structure of the inguinal canal. The spermatic cord and the vas deferens are partially connected to the hernial sac, the male patient must be operated very carefully.

An umbilical hernia is almost never infringed, here you can often do without surgical intervention. Girls are operated on if the umbilical ring is expanded. Now bloodless operations, without incisions, are becoming popular. Children tolerate them well, do not feel severe pain and do not face complications. Mom during the operation next to the child. The body quickly recovers, after a couple of hours you can return home.

It is important to keep in mind that inguinal hernia in children is a very dangerous disease and if you find obvious symptoms of an inguinal hernia in your child, you should seek qualified help from a pediatric surgeon as soon as possible. Only a specialist should decide what kind of treatment the baby needs. In some cases, it is enough to perform reduction (on early stage hernia formation). But in most cases, surgery is indicated to restore the anatomy as quickly as possible. abdominal canal and remove the hernial sac.

Next article.

An inguinal hernia is a condition in which the hernial sac protrudes through the peritoneum. Inside the bag are the internal organs, so their location changes, and their functions deteriorate.

And now let's dwell on this in more detail.

What is an "inguinal hernia"?

A hernia can occur in different areas, with inguinal localization, the bladder and intestines usually come out. This happens through the inguinal gap, which is located between the muscles and ligaments. In girls, the ligament of the uterus can also enter the hernial sac, and in boys, the spermatic cord.

Pathology is congenital and acquired. It often occurs in premature babies. The bulge itself may be painless, but when physical activity pain is felt and symptoms of disturbances in the functioning of internal organs occur.

Complete disposal of a hernia is possible only by surgery, which is recommended for children whose pathology is visible from birth. Often the disease is combined with others - dropsy of the testicle, dysplasia hip joint, spinal anomalies. In boys, the problem occurs several times more often than in girls. This is due to the peculiarities of intrauterine development, during which a channel is formed for lowering the testicles into the inguinal region. Normally, the hole should close, if this does not happen, an inguinal hernia occurs. Clinical manifestations are not always noticeable immediately and may appear during the life of the child.

The danger of the disease is that during physical activity, a hernia may be infringed, after which the internal organs do not retract themselves into the peritoneum. This leads to their dysfunction and the appearance of additional symptoms.

What does an inguinal hernia look like in children with a photo

The degree of protrusion with a hernia can be different. Often it is imperceptible in the supine position and appears only when the muscles of the peritoneum are tense, for example, while the child is crying or laughing. In boys, a hernia is similar to dropsy of the testicle, in girls it has a more characteristic appearance. Examples of inguinal hernia are shown in the photo below:

The first signs of an inguinal hernia

Congenital inguinal hernias are noticeable immediately after birth. The first sign is a protrusion of the skin in the form of swelling. It is painless, has a rounded shape and can completely disappear in a calm state of the child. With a large size of a hernia, it is not difficult to notice it, with a small one, it is detected a little later, when the child begins to be active or cry.

Hernias are right-sided and left-sided. In some cases, a pathological protrusion is formed on both sides. In addition, oblique and direct formations are distinguished, and several types are distinguished, depending on the degree of mobility, which is important for the doctor.

Symptoms of an inguinal hernia

The swelling itself is painless, however, during the movement of organs through the hernial fissure and back, the child may experience discomfort. Some complain of pulling pains, others - of a feeling of heaviness in the lower abdomen.

In boys, a hernia leads to stretching and asymmetry of the testicles. In the place of localization of the hernia, the scrotum will be enlarged. In girls, this is observed with the labia - one of them will be clearly larger. Hernial protrusion does not always descend into the genitals, but may remain in the lower region of the peritoneum. In this case, the swollen ball will be seen much better. More often the protrusion occurs on the right side.

Organs trapped in the hernial sac can be compressed during movement. This leads to infringement of the hernia and closure of organs with outside peritoneum. This condition is accompanied by circulatory disorders, increased intra-abdominal pressure, flatulence, and pain.

When an infringement occurs, the child begins to cry sharply, becomes restless and complains of pain. The bulging area cannot be set back, becomes hard, tense and painful. Almost always, the intestines will get into the hernial sac, so its infringement leads to intestinal obstruction. As a result, the child develops bloating, an inflammatory process develops, and later necrosis of the walls of the organ. With absence emergency assistance there is a possibility of perforation of the intestinal wall and the development of peritonitis.

Especially dangerous is the violation of the blood supply, which occurs when infringed, for girls. Inadequate nutrition of the tissues of the ovary and genital organs leads to the death of eggs and necrotic processes.

Causes and prevention of inguinal hernia

In children, inguinal hernias are predominantly a congenital feature. At the stage of fetal formation, the child has a vaginal process, which at the 12th week of development resembles a protrusion. After performing its functions, the process overgrows, and violations of this process lead to the formation of cracks and the appearance of a hernia after birth. Premature babies are more likely to develop a hernia because the area does not have time to heal. This process is the hernial sac into which the internal organs enter: in girls - the intestines, ovary and fallopian tube, in boys - the intestines, spermatic cords.

It is believed that the disease can be inherited. Approximately 11% of children with inguinal hernia had a relative with a similar pathology.

It is widely believed that a hernia can be acquired if the child carries heavy weights or cries too much. In fact, this happens very rarely. Basically, acquired pathologies can be in boys of school or transitional age who are engaged in strong physical exertion and at the same time have a congenital weakness of the abdominal wall.

Thus, an inguinal hernia is formed even before the birth of a child, but the pathology can increase in size with intense physical exertion, which is why many consider the hernia to be acquired.

Of the provoking factors that lead to the protrusion of the hernial sac, doctors distinguish the following:

• cystic formations in the ovaries or spermatic cords;
• hip dysplasia;
• problems with the spine;
• obesity;
• constipation;
• coughing.

Hernia prevention includes timely detection of pathology and regular visits to specialists to monitor the dynamics of hernia development. Children are advised to exclude the provoking factors that are described above, and then the number of protrusions and pinchings will be much less.

To prevent an acquired hernia, it is recommended to take care of the overall health of the child. This includes moderate physical activity to help strengthen abdominal muscles, treat constipation, and proper nutrition to normalize the work of the gastrointestinal tract.

Diagnostics

Usually a hernia is diagnosed immediately after the birth of a child. Pathological protrusion is noticed by the parents themselves or is detected by the doctor during a routine examination of the baby. Results are required to make an accurate diagnosis. instrumental research, visual inspection and palpation, as well as the collection of anamnesis.

To make it easier to identify a hernia, the child is asked to bend over, strain, or cough. With tension in the abdominal muscles, the protrusion becomes more noticeable. After this, the child is asked to take a horizontal position. With an uncomplicated hernia, the internal organs are easily set back into place. If the intestine enters the hernial sac, then when it moves from the peritoneum and back, characteristic rumbling sounds can be heard.

After a preliminary diagnosis, the doctor sends the child to do an ultrasound. Ultrasound examines the pelvis, inguinal canals and peritoneum.

The specialist must also differentiate an inguinal hernia from other diseases that have a similar appearance (inguinal, femoral hernia, spermatic cord cyst).

Treatment of inguinal hernia

Only unimpaired hernias can be set back. If the organs are still pinched, the pathology is corrected only by surgical intervention. The quality of the result depends on the degree of neglect of the process and the stage at which treatment begins. Conservative therapy is theoretically possible, but is not currently used. It involves the constant wearing of bandages or compression underwear, which will prevent the organs from protruding outward.

Small children are operated on at the age of 6-12 months. The procedure consists in cutting off the hernial sac and restoring the normal anatomy of the inguinal canal. This may also require strengthening the affected area with your own tissues.

Surgical treatment can be carried out in an open way and with the help of laparoscopy. The second method is preferable because it has less side effects and requires minimal tissue incisions. When carrying out the procedure, the surgeon must be careful not to damage the spermatic cords, otherwise this will impair the reproductive function.

The operation is performed by a doctor in a hospital, and if the outcome is successful, the child can be transferred to home treatment.

When infringing the hernia of girls, an emergency surgical intervention is indicated, since there is a high probability of ovarian atrophy and impaired reproductive function. If a hernia is infringed in boys, measures can be taken for self-reduction of organs:

• take a warm bath;
• take antispasmodics to relax the muscles and expand the hernial gap;
• position the child horizontally or lift his pelvis up to make it easier for the organs to “return”.

The prognosis for a child with an inguinal hernia is, in most cases, favorable. In uncomplicated conditions, surgical treatment is very effective. Before surgical reduction of pinched hernias, it is necessary to first make sure that the organs are viable. If their blood supply was severely impaired, and necrotic areas appeared, the doctor performs a resection.

Complications

As a complication, a pinched inguinal hernia and the consequences that such a condition leads to are considered. It is impossible to predict the pinch in advance. It is a jamming of the internal organs between the muscles of the peritoneum, so that they are sticking out. In this case, the muscles often spasm, which is why it is impossible to return the contents of the peritoneum back. This often occurs when the intestinal loop is overcrowded, which got into the hernial sac and fell out after physical exertion.

When a child is pinched, urgent prompt assistance is required. The process is acute and occurs suddenly. The child suddenly experiences severe pain in the groin, feels nausea and seizures. The area of ​​the hernia that sticks out from the outside becomes hard and unreducible. The patient's condition deteriorates sharply and rapidly.

In addition to pain, pinching is dangerous because it prevents normal blood flow in organs that are outside the peritoneum. Within a few minutes, tissue appears in them, and after a few hours, necrotic processes develop. In 10% of cases with pinching, doctors diagnose gangrene. Such conditions are dangerous to the life of the child and can be fatal if timely assistance is not provided.

If parents are offered a hernia operation while the child is still young, they should agree. As you get older, the chance of pinching will increase. In addition, the baby will have to limit himself in many ways in everyday life until he gets rid of the problem. An inguinal hernia does not go away on its own and in any case it will have to be removed at some age.

Rehabilitation

After surgery, for the first time, the child is recommended to rest so that the work of the internal organs is restored and returned to normal. About a month later, doctors say to do special exercises physiotherapy exercises to strengthen the muscles of the abdominal wall and accelerate tissue regeneration.

To special exercise it is recommended to add breathing exercises, which improves homeostasis and the overall immunity of the child. Already a month after surgical intervention the doctor may allow you to visit the pool or engage in active walking.

It is very useful to attend massage sessions. Their goal is not only to strengthen the abdominal muscles, but also to normalize intestinal motility. Massage movements perform in the navel, groin, oblique abdominal muscles, as well as on the back along the spine.

Sometimes doctors recommend taking mild laxatives to avoid straining and straining the operating area during a bowel movement. Absolutely safe drug for children of any age is Dufalac. As an aid, postoperative bandages can be used. They need to be purchased in specialized places, taking into account the individual size of the child.

An inguinal hernia in a child is a defect of the abdominal wall, located in the inguinal region and characterized by protrusion of the internal organs outward through the formation of an oval protrusion. By increasing intra-abdominal pressure and expanding the inguinal canal, all organs located in the peritoneum, fatty tissue can protrude outward, thereby causing discomfort and pain in the groin.

An inguinal hernia can be either congenital or acquired. The hereditary predisposition to the formation of this formation is due to the fact that the low strength of the connective tissue that forms the muscular-tendon canal is not able to restrain intra-abdominal pressure. Acquired hernia, on the contrary, develops due to heavy lifting, systematic constipation, impaired urination and chronic cough.

The main factors contributing to the development of inguinal hernia include:

• Genetic, age and sex predisposition. The fact is that if a pathology was diagnosed in the anamnesis of the closest relatives, then the likelihood of its occurrence in a male infant increases several times. The same risk is observed in the elderly, because over time, the tone of the abdominal muscles decreases significantly.
• Obesity or excessive asthenia;
• More than 3 births;
• With the systematic performance of hard physical labor.

Even after surgery, the risk of recurrence of the pathology tends to 100% if the patient does not change gender labor activity(for adults). Diseases accompanied by a constant cough can also provoke the development of an inguinal hernia. For example, chronic obstructive disease lungs, bronchitis, etc.

Classification

According to the clinical classification, protrusions are divided into:

• Direct. Refers to purchased. Their main characteristic is the formation of a protrusion of the peritoneum directly through the inguinal canal, while skirting the spermatic cord.
• Oblique. They can be either congenital or acquired. Their main characteristic is that the contents of the hernial sac enter the inguinal canal through the inner ring and pass close to the spermatic cord.

Inguinal hernia in patients childhood much less common than in adults. Despite this, every parent should remember that if any incomprehensible changes appear on the child’s body, it is necessary to seek medical care.

Symptoms and signs

Complaints of patients directly depend on which organs were infringed during the formation of a hernia, on the size of the sac and the development of any complications. As a rule, the main symptom of pathology is the presence of a protrusion and its soreness.

Complaints collected define features individual approach to a further algorithm for performing an inguinal hernia operation in a child or adult. During an objective examination of the patient, attention is paid to:

• the size of the spherical formation in the groin area;
• determination of the intensity of pain during palpation of the abdominal cavity and protrusion;
• the presence of frequent two-stage urination, which is a sign of involvement Bladder inside the hernia.

In some situations, a hernia can repair on its own, especially when patients lie on their backs. If it is impossible to reduce the hernial contents into the peritoneal cavity, it is customary to talk about its irreducible variety.

Diagnostics

In most cases, the diagnosis of a hernia in the groin does not create any difficulties: a visible protrusion can be easily detected during a physical examination.

With the development of a volumetric hernia in males, as a rule, one half of the scrotum increases, its skin stretches, and the penis deviates in the opposite direction.

If untimely seeking help, the hernial sac can grow to gigantic sizes. and completely hide the penis in the folds of the skin.

During palpation, the specialist evaluates the shape and volume of the hernial sac in the position of the patient lying and standing. In total, there are two options for its location:

• oblique hernia - the protrusion has an oblong shape and is located in the region of the inguinal canal (along its course), in some situations it can move into the scrotum;
• direct hernia - a formation that has a round or oval shape and is located in the region of the median part of the inguinal ligament.

If the protrusion is located above the projection of the external opening of the inguinal canal, then it is necessary to carry out differential diagnosis with parainguinal and interstitial hernia. In the presence of two protrusions, the development of a combined hernia can be suspected.

Where the danger lurks

• pinching of the hernial sac;
• development of intestinal obstruction;
• occurrence inflammatory process between the sheets of the peritoneum (peritonitis);
• bleeding;
• the spread of inflammation in the scrotum;
• development of an unreduced hernia.

Conservative treatment

At the moment, the bandage is a scourge among patients and parents of children who have undergone the formation of this pathology. The fact is that this device helps to reduce the load on the inguinal region and reduce pressure in the hernial sac. The use of a bandage can have a therapeutic effect only with a reduced hernia at the initial stages of the disease.

The use of this type of canning therapy in children can lead to the development of the following consequences:

• growth of the area of ​​hernial protrusion due to tissue scarring;
• compression of the contents of the hernial sac;
• development of atrophy in the area of ​​fascial edges;
• compression of the spermatic cord.

Treatment of inguinal hernia in children without surgery is possible, however, the indications for its implementation should be justified solely by a specialist based on the history and diagnosis. Movement is life. This statement should be remembered by every parent and to prevent the development of inguinal hernia in children with a predisposition to this disease to instill a love of sports from childhood. Thanks to systematic exercises, the abdominal muscles will get stronger, and the risk of hernia formation will decrease.

Methods of surgical treatment

The three most commonly used methods are currently surgical treatment inguinal hernia in children. These include:

• Stretch method. When using this method, the removal of the hernial sac occurs through the use of the patient's tissues. The edges of the formed defect are subsequently tightened with a seam. Today, this technique is used less frequently due to the high risk of recurrence and the difficult recovery period.
• Tension-free hernioplasty. Elimination of a hernia defect is carried out by using a special synthetic mesh, which plays the role of a kind of frame and barrier that prevents the recurrence of a hernia.
• Laparoscopy. This is the most gentle surgical intervention. Through several small incisions, trocars, an endoscope and the necessary instruments are inserted into the abdominal cavity. Meshes are also placed using laparoscopy.

At present, it is becoming more and more common one day surgery. Laparoscopic surgery for hernia in children is a method of treatment with minimal tissue trauma and the shortest recovery period.

Whether an operation is needed if the patient is diagnosed with an inguinal hernia is described in an interview with a practicing surgeon.

Ultrasound procedure

In pediatric patients, as a rule, ultrasound examination of the inguinal canals and scrotum is used for diagnosis. Thanks to ultrasound, the following features can be determined:

• localization and size of hernial formation;
• determination of the internal organs involved in the pathological process;
• condition of the walls and openings of the channel.

Also, thanks to ultrasound, it is possible to determine whether the ovaries and fallopian tubes are affected, and what part of the intestine is located in the hernial sac.