Inguinal hernia in a boy what to do. Inguinal hernia in children treatment and surgery

An inguinal hernia is one of the most common types of external hernias. Boys and adult men suffer from this pathology more often. This is due to differences in the structure of the body. In women, the muscles of the press and the inguinal region are better developed, as nature intended for the purpose of bearing and giving birth to offspring.

Inguinal hernia is a pathology that can be acquired or congenital and will manifest itself immediately after the birth of the baby.

What is an inguinal hernia?

An inguinal hernia in children is a protrusion of the abdominal organs into the inguinal canal (a small gap between the abdominal muscles). Inside this gap in boys is the spermatic cord, in girls - a round ligament of the uterus.

A hernia consists of a hernial orifice, a hernial sac and contents (what has fallen into the inguinal canal). Pathology looks like a small tumor-like formation in the groin area, increasing in size while standing. The protrusion is successfully treated, especially with timely detection.

Causes of inguinal hernia

Congenital hernia in boys

In early childhood, congenital hernias are more common. The testicles in boys are not formed in the scrotum, but in the abdomen, and gradually descend down, resulting in the formation of the vaginal process, which is a kind of pocket from the peritoneum. By the age of two, it closes and overgrows. If the process does not close, there is a danger of an inguinal hernia. A loop of intestine, greater omentum, bladder, appendix can get into the hernial sac. Genetic predisposition increases the risk of hernia in children.

Congenital hernia in girls

In girls, the mechanism of formation of hernial sacs is similar. They arise due to the pathology of the development of the round ligaments of the uterus. During fetal maturation, the uterus is located above its usual location. Gradually, she begins to descend into the small pelvis, pulling the peritoneum behind her. A pocket is formed - the same as in boys, into which internal organs can fall out.

Acquired hernia

Acquired inguinal hernias are rare in children. In infancy, they appear with excessive tension of the abdominal muscles when coughing, constipation or vomiting, a significant body weight of the baby, underdevelopment of the abdominal wall. During puberty, they often appear in boys, the development of pathology is possible for the following reasons:

• weakness of the muscles of the abdominal wall;
• peritoneal injury or groin injury;
• increased intra-abdominal pressure;
• excessive physical activity;
• weight lifting.

There are many reasons that provoke the occurrence of an acquired hernia, but the main factor is weakened abdominal muscles due to a genetic predisposition or a sedentary lifestyle. In sports, a lot of moving people, hernias are extremely rare.

Types of disease

Inguinal hernias are straight and oblique. Oblique hernias pass through the inguinal canal along with the spermatic cord, direct - outside it. Indirect hernias are of three types: canal, cord and inguinal-scrotal. With the inguinal-scrotal variant, the hernial sac is located in the scrotum. There are also combined hernias. They consist of several hernias that are not interconnected.

According to their characteristics, hernias are divided into reducible and irreducible. The former tend to appear and disappear on their own, while the latter cannot be eliminated (reset) due to the fusion of the hernial sac with its contents.

Symptoms of pathology

Symptoms of abnormal protrusion are very characteristic:

1. Swelling in the groin area, which increases from exertion (from loud screaming, hysterical crying, straining) and in an upright position.
2. Inguinal hernia in boys is often oval in shape, in girls it is round.
3. The reduction of an uncomplicated inguinal hernia is painless and is not accompanied by any discomfort. It happens with light pressure.
4. With a complicated process, pain, burning, constipation appear. When loops of the intestine enter the hernial sac in the abdomen, a soft rumbling sound occurs.

An inguinal hernia is dangerous for a child due to the fact that there is a possibility of infringement of organs that have fallen into the hernial sac. As soon as parents suspect a pathology in a child, they should immediately contact a specialist (urologist or surgeon). The effectiveness of treatment depends on early diagnosis.

Diagnostics

The specialist will detect the pathology during the examination. The hernial sac becomes more visible when the body is upright. On palpation, a soft elastic formation is detected. After that, an ultrasound diagnosis of the abdominal cavity or pelvic organs (girls) is performed.

Ultrasound examination to detect pathology

If a decision is made to perform an operation, a more detailed examination is carried out, including the following tests:

• clinical blood test;
• blood clotting;
• general urine analysis.

Sometimes an additional x-ray of the intestine is made with a contrast agent - irrigoscopy. The procedure determines the presence or absence of pathology in the colon in children. Girls are more difficult to diagnose. When the fallopian tube or ovary is infringed, the pain is much weaker than when squeezing the omentum or part of the intestine.

Conservative therapy

After the child has been diagnosed with an inguinal hernia, in the absence of indications for surgical intervention, conservative treatment is performed aimed at self-reduction of the hernial sac. The patient is prescribed Pantopon in a single dose, after which he is immersed in a warm bath for 15 minutes (water temperature is about 38 degrees), or a heating pad is applied to the inguinal region.

After the procedures, the child calms down and falls asleep. Spontaneous reduction of the hernia occurs. A positive effect is observed in 1/3 of cases.

Conservative treatment lasts no more than 1 hour. This is the maximum duration of therapy. If after an hour the protrusion does not decrease, a decision is made on the appointment of the operation. If spontaneous reduction occurred before the onset of anesthesia or as a result of conservative measures taken, the baby is left in the hospital until a planned operation.

Sometimes doctors recommend that the patient wear a special bandage (look at the photo how it looks) that supports the anterior abdominal muscles and restricts the movement of internal organs, which prevents protrusion. The bandage is worn during the day and removed at night. Sometimes it is left if the child coughs at night or wakes up screaming and crying.

A bandage is not an alternative to surgery, but a temporary measure. The patient is additionally prescribed massage and physiotherapy exercises in order to strengthen the abdominal wall. The condition of the child is carefully monitored, even if therapy gives a positive result, since the likelihood of relapse before 4 years is high.

Methods of surgical treatment

Sometimes without surgical treatment with such a pathology can not do. The procedure is carried out at the age of one. With the help of special tools, the doctor separates the hernial sac and the abdominal cavity, placing the internal organs in their anatomical places. The patient is operated on under general anesthesia. Parents are concerned about how long the operation takes. The procedure takes 15-30 minutes. The technique for performing the manipulation is simple, but the doctor must have the appropriate qualifications.

There are 2 ways to remove an inguinal hernia: open (hernia excision) and laparoscopic. According to the method of strengthening the walls of the inguinal canal, hernioplasty can be tension and tension-free. During tension plastics, the walls are sutured, with a non-tension method, the walls of the canal are reinforced with synthetic materials (polyester or polypropylene mesh).

With absolute indications for urgent surgical intervention, preoperative preparation is not carried out.

The exception is belated appeals (4-5 days). Patients are admitted in a serious condition with severe intoxication, dehydration, and often already with peritonitis - inflammation of the peritoneum.

Before the operation, the following manipulations are carried out:

• injected intravenously with a 10% glucose solution;
• perform blood transfusion;
• give antipyretic and cardiac drugs.

hernia excision

Hernia excision is an obsolete term for an operation to remove a hernia. There are about a hundred options for hernioplasty. The method consists in the fact that when a hernia is removed, an external incision is made in the anterior wall of the abdomen at the site of the protrusion, the hernia gate is sutured, and the walls of the inguinal canal are strengthened. For a child, this method is not dangerous: the procedure lasts 15 minutes and is easily tolerated by the baby. On the same day, the patient is discharged from the hospital.

At home, it is important to observe bed rest for 3-4 days. The child is prescribed laxatives and a special diet. The sutures are removed 7 days after the operation. Physical activity is not recommended for the next 6 weeks.

Laparoscopy

An alternative to the traditional surgical method is laparoscopy. This is a closed operation performed using a laparoscope. Removal of a hernia occurs without an incision in the peritoneum, through punctures in the navel. Under the control of the equipment, the doctor performs tissue plastic surgery with the installation of a reinforcing mesh. Laparoscopy of an inguinal hernia has several advantages:

• the procedure is not as traumatic as hernia repair;
• the recovery period of the child is shorter;
• there are fewer recurrences and complications in the form of damage to the spermatic cord are excluded.

Incarcerated hernia - an indication for emergency surgery

The situation becomes critical when the hernia is incarcerated. In this situation, surgery is needed immediately. The most life-threatening is the incarceration of the intestine, as this can lead to intestinal obstruction and tissue necrosis.

Determining abuse is easy. Symptoms may develop rapidly. The main symptom is a sharp and sharp pain in the groin.

The child becomes restless, cries, screams loudly. At the beginning of the infringement process, diarrhea, vomiting, then constipation occurs. If the baby has similar symptoms, it is urgent to take him to the hospital.

Postoperative Therapy

After the operation, the patient must follow the recommendations of the doctor. This will prevent inflammation of the seams, the occurrence of relapses and other problems during the rehabilitation period. Necessary:

• take broad-spectrum antibiotics;
• wear special elastic panties that support the scrotum until it heals;
• observe a special diet (foods with a high content of fiber and protein);
• give up physical activity.

Are relapses possible?

Hernia recurrence is a serious postoperative complication. Elimination of a newly appeared protrusion is a technically complex and traumatic operation. Re-growth of an inguinal hernia occurs in 1% of cases. This mainly occurs in connective tissue pathology and in premature babies.

Unfortunately, in modern pediatrics, surgery is often diagnosed. Surgery is sometimes the only possible way of treatment. Of course, this pathology is of great concern to 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 the disease be and what methods of treatment does modern medicine offer? What are the causes of the development of pathology and what external signs does it accompany? 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, 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 group with an increased risk. 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 responds well to treatment, especially if diagnosed early. Nevertheless, it is worth studying in more detail the causes and symptoms of this pathology.

The main causes of the development of an inguinal hernia in a child

Many parents ask the question of why a 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 overexertion. Naturally, if we are talking about a child, then stress is not associated with physical activity or lifting weights. With weakness of the abdominal wall, protrusion of the abdominal organs may appear as a result of severe coughing or vomiting.
• Sometimes a hernia is the result of an injury to the abdominal wall, including during fetal development.
• This pathology may be the result of overweight in a child.

Disease pathogenesis

As already mentioned, a hernia is more often diagnosed in boys, which is associated with the peculiarities of anatomical development. Initially, the testicles of the fetus are located in the region of the kidneys. Closer to childbirth, they descend into the scrotum, dragging part of the peritoneum with 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, for one reason or another, this does not happen. The presence of a pocket increases the likelihood of protrusion of internal organs.

In addition, the inguinal canal in men is much longer than in women, which also increases the risk of hernia. As for girls, their pathology is associated, as a rule, precisely with the weakness of the connective tissue, as well as physical overstrain. It is worth noting that a hernia can be congenital or begin to develop after the birth of a child. Protrusions can appear both on one (usually on the right), and on both sides. Sometimes children are diagnosed with a postoperative inguinal hernia, although in fact the cases of recurrence with a correctly performed procedure are minimal.

What are the symptoms of the disease?

Sazu is worth noting that the signs directly depend on the degree of protrusion. Typically, a hernia is a small, oval, sometimes triangular sac located either above the pubis or on the outside of the pubis. The bulge tends to become more noticeable in an upright position. The hernia also increases with an increase in intra-abdominal pressure, which is observed, for example, during screaming or crying.

Sometimes it causes severe paroxysmal pain. Soreness makes the child restless, he often cries, does not sleep well. Other symptoms include nausea, loss of appetite, and vomiting.

If we are talking about boys, then the inguinal hernia can move towards the scrotum (it is called an oblique hernia). In such cases, there may be an increase in the scrotum, swelling in the perineum.

Now you know how an inguinal hernia is determined in children. Surgery is not necessary in all cases. Nevertheless, if you notice alarming symptoms, then the baby should be shown to the surgeon without delay. The sooner the diagnosis is made and treatment started, the less likely it is to develop complications.

Complications arising from a hernia

In fact, inguinal hernia is a rather serious problem. If the child has not been 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 abnormal development of organs. In boys, the consequences of a hernia can be pathologies of the reproductive system.

Nevertheless, the most dangerous complication of an inguinal hernia is its infringement. A similar situation is associated with pinching of tissues and disruption of normal blood circulation in a particular organ. In turn, this situation is fraught with tissue necrosis, inflammation, blood poisoning, etc.

Infringement and its symptoms

Infringement of a hernia is a critical situation, especially when it comes to a small child. In such cases, surgical intervention is simply necessary. An increase in abdominal pressure can provoke an infringement of a hernia, which, for example, is observed with strong screaming and crying, physical exertion, coughing, vomiting, etc.

Determining the presence of infringement is quite simple. becomes more convex and firm to the touch. Palpation causes pain. 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 fever, fatigue, loss of appetite, vomiting, drowsiness, irritability. If you notice similar symptoms in your baby, you should immediately take him to the hospital, since the lack of qualified assistance can lead to mass necrosis, pain shock, etc.

Modern diagnostic methods

It is possible to suspect the presence of pathology already during a general examination. becomes visible in an upright position, as well as during coughing, crying, etc. On palpation, the doctor can feel a soft elastic formation. By the way, sometimes a hernia can be corrected - to place the internal organs back inside. Naturally, a specialist should carry out the procedure, and not all bulges lend themselves to such manipulation. If the bag contains part of the intestine, then you can hear a characteristic rumbling sound.

In the future, as a rule, an ultrasound examination of the abdominal cavity or pelvic organs (in girls) is performed. Only after that, the doctor can decide whether surgery is needed to remove the hernia.

In the event that the specialist has decided to perform a surgical intervention, a more detailed medical examination is necessary, which includes general blood and urine tests, an ESR test and blood clotting. Sometimes an irrigography is additionally performed - 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 you to determine the presence of pathologies or abnormalities in the development of the large intestine.

Are there effective methods of conservative treatment?

Immediately it should be said that conservative therapy is possible only in cases where 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 reduced. This device supports the abdominal wall and keeps the internal organs from protruding. As a rule, the inguinal bandage is worn during the daytime. However, it can be left overnight if the child suffers from a nocturnal cough, for example.

The bandage is not an alternative to surgery, but only a temporary measure. The little 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 child's condition must be carefully monitored, since the likelihood of relapse in the first 4 years of life is high.

Inguinal hernia in children: surgery

Sometimes without surgical intervention with such a 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 separates the hernial sac and the abdominal cavity. In this case, you need to ensure that the internal organs remain in place. The surgery is performed under general anesthesia and lasts about 30 minutes. That's what it looks like

Health is very vulnerable in childhood, negligent attitude brings the baby many problems in the future. While an older child can clearly articulate what is bothering them, it is not easy to understand why an infant is crying. In the case of an inguinal hernia, parents should familiarize themselves with the symptoms in advance and monitor them.

A bulge in the groin and scrotum is called an inguinal hernia, which often appears on one side, but can be bilateral. The contents of the bag are intestinal loops, which until a certain time are reduced with pressure. The disease is common among, however, unlike other species, it is not easy to detect before it grows. In adulthood, physical activity becomes provoking factors, in children there is a congenital pathology.
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Causes and manifestations

More often inguinal hernia in boys, causes which is congenital, occurs as a result of an unclosed canal of the vaginal process, through which the testicles descend into the scrotum. In older children, opening can be provoked by:

• injury;
• physical stress;
• excess weight.

The child must be treated for a strong cough, which causes an overstrain of the abdominal walls. Older boys should lead a mobile, age-appropriate lifestyle and monitor nutrition.

Inguinal hernia in children, signs which is not easy to determine, due to the absence of pain, does not bother the boys at the initial stage. Accordingly, it is difficult to judge the presence of an ailment without clinical manifestations. The course of the disease is characterized by the following symptoms:

1. The formation of swelling in the groin, which can change in size with a change in body position.
2. Pain of a aching nature, which, depending on the severity of the form of the disease, can be short-term or long-term.
3. Burning in the groin, worse after physical activity. Babies start crying after moving.

Understand, what does an inguinal hernia look like in boys You can, if you look at its structure.

Inguinal hernia in children, symptoms which is not outwardly expressed, it is possible to see when the child begins to cry, cough or scream, due to tension, the bump in the groin area becomes visible. Other manifestations of the disease include:

• bloating;
• diarrhea
• indigestion;
• stretching of the scrotum from the side of education;
• pain.

Inguinal hernia in a child, symptoms which is characterized by protrusion into the abdominal region, is more common than other types of hernias in infancy.

Inguinal hernia in boys, symptoms which indicate infringement, requires the immediate call of an ambulance.

Effects

The main danger of the disease lies in the fact that the hernial gate pinches the organs contained in the bag, as a result of which there will be acute pain and the inability to independently correct the protrusion.

Infringed inguinal hernia in boys, consequences which, in the absence of timely treatment, can be fatal, manifests itself as follows:

• there is severe pain in the abdomen;
• there is redness of the abdominal region;
• the stomach swells;
• stool retention occurs;
• the child does not pass gases;
• nausea or vomiting appears, the latter is considered a dangerous symptom.

If a hernia has formed in a baby, then he begins to cry nervously, tighten his legs in pain. In the pinched loop of the intestine, the outflow of blood is disturbed, inflammatory processes and tissue necrosis begin. The risk of complications after the condition is high. Even after repositioning the contents of the bag, adhesions often appear, resulting in intestinal perforation and peritonitis.

Treatment

When was formed inguinal hernia in a boy, what to do in such a situation, only an experienced doctor can determine, who most often prescribes an operation. Surgical treatment begins with the preparation of the child, during which he must:

• take blood and urine tests;
• undergo an ultrasound;
• be examined by a cardiologist, ENT, neurologist.

The operation is not considered difficult, the duration is 30 minutes. Before the procedure, the child is limited in the intake of food and water. No less important is the psychological attitude for boys. Parents should give him a lot of attention and care, explain that they will not leave him alone in the hospital, that he will not be hurt, you can beat the action of the procedure on toys, so it will be easier for the baby to cope with anxiety.

The operation, in the absence of contraindications, can be performed from 6 months. The mother is allowed to stay with the child in the ward until the age of 3, but most hospitals do not provide them with separate beds, in such cases you can bring a cot with you. Older children are allowed to visit their parents from 8 am to 8 pm. Some hospitals provide paid wards "mother and child".

Laparoscopy and rehabilitation

Laparoscopic hernioplasty is a common surgical treatment of inguinal hernia in children. The laparoscope used, thanks to a video camera with illumination, helps to see the injury site from the inside, which makes it possible to carry out the operation with incisions not exceeding 2 cm. Such injuries heal quickly and do not leave scars, for this reason the technique is called cosmetic.

I insert 3 tubes (trocars) into the abdominal region, they also make incisions. One of them is placed in the umbilical region, a laparoscope is passed through it. The rest are used for the introduction of tools: a tissue clamp and a mesh fastener. The synthetic implant is fixed to the hernial orifice and sutured.

relapse

In some children, the reappearance of the disease is possible, the reasons for this are:

• mistakes during the operation, the risk of which will be reduced by choosing an experienced doctor and a hospital with good recommendations;
• regular constipation, which primarily needs to regulate nutrition and increase fluid intake;
• physical activity in the rehabilitation period. During the rehabilitation period, it is forbidden to make sharp bends, pump the press, do deep squats, do push-ups and lift weights. To avoid this, children need to take an exemption from physical education or exercises in kindergarten from a doctor;
• the formation of pus in the area of ​​​​the suture, the appearance of which is possible in children with low immunity, in which the body has a hard time coping with microorganisms from the air or an anaerobic infection.

Inguinal hernia in children, boys, treatment which was performed by laparoscopy, has a reduced percentage of re-education.

Rehabilitation

After the procedure, babies are rarely left in the hospital. In the absence of complications, pain disappears after 3 days. Older children are contraindicated in physical activity for a period of at least 6 months. The doctor recommends reducing portions of food during the rehabilitation period. The diet should contain products from the recommended list.

Treatment without surgery

Inguinal hernia in boys, treatment without surgery provided in cases where the infant is premature, other contraindications to surgery include:

• acute renal failure;
• heart and lung diseases;
• purulent peritonitis;
• sepsis;
• infectious diseases;
• adhesions in the abdominal region;
• blood clotting disorders;
• intestinal obstruction;
• recent operations;
• obesity and others.

Surgery is the only way to treat a hernia, conservative methods prevent complications and help eliminate symptoms. Patients' cases are considered on an individual basis and the indications for surgery are determined by the doctor.

Physical exercise

Inguinal hernia in children as treatment without surgery includes wearing a bandage while performing recommended physical exercises, massage and alternative medicine. Rhythmic movements and other requiring strong tension in the inguinal region are contraindicated. Children at the age of 3 can, under the supervision of their parents, perform the following exercises:

1. In a horizontal position, the knees are bent, and the hands are closed behind the head. After that, the knee of one leg is connected to the elbow of the opposite hand and returned to its original position. Then, the actions are repeated by the other side, the number of approaches for the child is determined as far as physical fitness, the more times he does, the better. The exercise is repeated 2 times a day.
2. For the next exercise, you need to lie on your back and stretch your arms along the body, then a weighting agent, weighing 500 grams, is placed on the abdominal region. for children, weight is added over time. After that, the child should raise the stomach to the limit with inhalation, and retract it with exhalation.
3. The action consists in raising the small pelvis, in a horizontal position. At the same time, the legs are bent, and the arms are placed freely.
4. The exercise is performed with an elastic bandage, from which a loop with a diameter of 30 cm is made, which is made by preliminary stitching the edges, and put on the raised legs in a supine position. Next, the child stretches the material with his limbs.

For babies, parents massage the groin area to improve muscle tone, which is alternated with pinching, pressing and stroking.

Physical education helps to strengthen the abdominal walls and prevents congestion, but should be done after consulting a doctor. The absence of an operation obliges a person to regularly perform therapeutic exercises for the rest of his life!

Recipes

Natural ingredients are used for rubdowns, compresses on the affected area and ingestion. Dosage and suitable remedy are agreed with the pediatrician. The exact percentage of the effectiveness of the procedures is not clinically confirmed.

Salted cabbage brine

Treatment involves applying brine compresses to the site of the tumor, additionally using sour vegetable leaves.

Oak poultices and hernia poultices

The infusion for the compress is prepared from crushed leaves, acorns and tree bark, which are poured with wine and removed in a dark place for 3 weeks. Previously, before the procedure, the inguinal area is wiped with cold, acetic water, in the proportion of 1 cup to 2 tbsp. spoons of 4% solution. A warm compress is left for half an hour, it is recommended to alternate with herbal poultices.

Herbs for oral use

Herbal infusions are taken 2 hours before meals, the method of preparation is to brew with boiling water. A glass of medicine is drunk per day, divided into 3-4 doses. Plants useful for hernia are:

• spiraea;
• gooseberry casting;
• cornflower flowers;
• bony leaves;
• immortelle;
• horsetail and others.

For young children, the dosage is reduced, on pharmacy herbs it is indicated on the package, with self-collection of plants, the number of uses is specified by the pediatrician. Treatment of diseases should not be postponed until later, waiting for the recurrence of symptoms, for this reason, the mortality of children increases!

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 the protrusion of the internal organs of the peritoneum under the skin through natural openings located in the groin. There are many or one protrusion in children. The most common reason for this is the thin structures of the 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 infants, the main cause of the manifestation 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:

• take a general blood test;
• 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 the latest technique, which is considered less painful and traumatic. Its main advantage is the complete absence of 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 perform an 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 baby is given 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 a hernia has been infringed, then conservative or alternative treatment cannot be used. 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. You need to take the leaves of a medicinal plant, steam it and apply it to the diseased 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 of 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 an additional remedy, but by no means 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:

Symptoms of inguinal hernia in infants

The main symptom of the disease is a pathological protrusion (hernia) observed in the groin area, which can be oval or round in shape. Depending on the position of the body the baby occupies, it can become larger or smaller. When a child cries, pushes too hard, parents may see a swelling that is in the form of a small bump. An inguinal hernia in an infant is soft to the touch, as a rule, it does not cause pain to a child, and it is easy to set it into the baby's abdominal cavity.

If swelling is found in the groin or scrotum, you should immediately consult a doctor for an accurate diagnosis and the appointment of an appropriate course of treatment. The problem is that the symptoms of an inguinal hernia in a newborn baby are very similar to those of dropsy of the testicles and cysts of the spermatic cord. These diseases are often combined.

The most dangerous complication of an inguinal hernia in an infant is an infringement, which manifests itself when the organs are squeezed by the inguinal gate. At the same time, the education in the groin of the child hardens and it is no longer possible to set it into the abdominal cavity. The child may experience nausea, bloating, problems with stools, and vomiting. The clamped organ may subsequently be completely lost, so surgical intervention should be performed immediately.

Often in the groin of a child, a loop of the intestine is clamped, as a result of which the outflow of venous blood in the intestine decreases, blood circulation fails, edema occurs, which leads to necrosis of the intestinal wall, and this is the path to peritonitis and perforation.

Weakening of the connective tissue of the peritoneum is very dangerous, therefore, in order to avoid serious consequences, you should consult a doctor if symptoms of an inguinal hernia are detected in an infant. Only a doctor, after conducting the necessary examination, is able to make his own conclusion and recommend specific methods of getting rid of the disease.

Symptoms of pinched inguinal hernia in infants

Pinched inguinal hernia is accompanied by bouts of pain that occurs unexpectedly and has sufficient severity. In this case, the pain may not be localized at the site of infringement, but spread throughout the body. At the same time, the child becomes restless, during the first few hours after the manifestation of pain, he may experience loose stools, after which there may be no stool, as well as gas, for a long time.

At the initial stage of pinching, the child may experience vomiting, which will gradually intensify as the pinching lasts. The bladder will continue to squeeze, which causes more frequent urination and its intensification. The child's heart rate will increase, fever may increase, accompanied by a decrease in blood pressure. Possible false urge to defecate. As the pain syndrome intensifies, the child's anxiety will increase and the symptoms of an incarcerated inguinal hernia will increase quickly enough.

Causes of inguinal hernia in infants

An inguinal hernia is the exit of the abdominal organs into the abdomen through the inguinal canal. When lowering the hernial formation in boys into the scrotum, the hernia is called inguinal-scrotal. Boys have inguinal hernias ten times more common than girls, and premature babies are five times more likely than full-term babies. Mostly inguinal hernias affect children with an abnormal structure of connective tissue and genetic pathologies.

Inguinal hernias in newborns are often combined with hernias of other types of abdominal wall. Hernias in the inguinal region may accompany congenital pathologies of an orthopedic nature, developmental deficiencies of the nervous system. The location of the inguinal hernia on the right side is observed in more than half of all cases of inguinal hernias in boys, while in girls, bilateral inguinal hernias are mainly observed.

One fifth of all inguinal hernias are caused by a genetic predisposition to them, in the event that one of the relatives has previously been operated on for this reason. There is a widespread opinion in the medical environment that the cause of a hernia in the groin is inherited - a defect in the connective tissue.

In addition to a hernia, dropsy of the egg membranes, cysts of the spermatic cord may appear. The most important role in the formation of an inguinal hernia is played by the vaginal process, which begins to develop from about the tenth week in the abdominal cavity of the unborn child. He is responsible for the installation of the genital organs in their proper place, this primarily applies to the testicles, which are laid in the abdominal cavity at great depth and descend into the scrotum in the eighth month of pregnancy.

An inguinal hernia is characterized by the formation of a hernial orifice created by the outer ring of the inguinal canal, as well as a hernial sac.

Inguinal hernia in a boy's baby

Very often, the boy's parents do not go to the doctor for help with the formation of an inguinal hernia in their child, for the reason that they believe that it does not cause significant inconvenience. Even if outwardly there is a feeling that the boy feels quite comfortable with a hernia, such behavior on the part of the parents will only lead to the creation of additional complications for the child. Complications may lie in the fact that other organs grow into the sac formed in the peritoneum, in the case of boys this refers to a fragment of the intestine, in girls this applies to the ovaries. The result may be the beginning of the process of inflammation due to the cessation of the blood supply to the above organs.

Another reason for the onset of the inflammatory process lies in the feces formed in this place. This is especially dangerous for the reason that the part of the intestine clamped by a hernia can atrophy during the day. This can result in overcooked food remaining in the upper intestines, causing the baby to hold stools and bloat. The child in this state experiences severe pain, vomits and vomits, and the nausea is prolonged and does not go away for a long time.

Inguinal hernia in a baby girl

The causes of congenital inguinal hernia in girls are different from the causes of inguinal hernia in boys.

Even before the birth of a girl, her uterus is significantly higher than its standard position. Then there is its gradual lowering, as a result of which it pulls the peritoneum along with it. As a result, the latter forms a fold that protrudes into the inguinal canal and creates a pocket there. This is the essence of the process of formation of inguinal hernia in girls.

In the event that an inguinal hernia was formed after the girl was born, the cause of its occurrence may be hidden in excessive loads, severe overstrain as a result of straining the abdomen.

An inguinal hernia has similar symptoms, regardless of whether it is congenital or acquired. It looks like a small protrusion, which increases in size with abdominal tension, crying, screaming, coughing and other types of physical stress.

An inguinal hernia becomes better visible if it descends and is localized on the labia majora. If complications are not observed, the hernia is soft to the touch and it is easy to set it into the abdominal cavity.

When pressing on it, a rumbling is heard, which becomes distinct if there are intestinal loops in the hernial sac. When the hernia is reduced, pain and discomfort are not felt. When infringed, the hernia becomes hard and visible when protruding, which causes anxiety to the girl and causes her to cry.

It is possible to diagnose an inguinal hernia in girls only after a surgical consultation by palpation, external examination, based on existing complaints. Unlike boys, an inguinal hernia in girls cannot be confused with a water membrane around the testicles.

Inguinal hernia in infants is treated by two methods: surgical and conservative. In the event that the hernia is not complicated by infringement, it is recommended that the child wear a support bandage until the age of five. Another method of conservative treatment involves the reduction of the hernial formation in the abdominal cavity.

However, infringement can manifest itself at any time and, as it is clear from the above, this process is quite dangerous. Parents should understand that once the diagnosis is made, surgery is the best treatment for an inguinal hernia in a newborn baby.

You should not be afraid of a surgical operation, since cutting out a hernia does not pose any danger to the life and health of the child. The operation, which lasts a quarter of an hour, is easily tolerated by a child. He is discharged from the hospital the same day, put on bed rest for four days, and the stitches are removed a week later.

Nevertheless, despite the seeming simplicity, the operation of cutting a hernia requires the precision of surgical execution. The specialist performing the operation must be a master of his craft and perform everything with maximum precision in order not to injure the closely located vas deferens and the spermatic cord in boys. If the operation is unsuccessful, a recurrence of the disease and complications with the patient's state of health are possible in the future.

As a rule, the operation is scheduled in a planned manner and soon after the diagnosis of the disease. However, if there is an infringement, the operation should be carried out urgently, immediately after squeezing the hernial sac. With the timely operation, the hernia does not leave any consequences for the health of the child.