Pediatric inguinal hernia Pediatric inguinal hernia is a common congenital abnormality of the abdominal wall and one of the common diseases in pediatric surgery. The main clinical manifestation is a reversible mass in the inguinal region shortly after birth, 80% of which appear at 2-3 months after birth, or as late as 1-2 years of age. Inguinal hernias are divided into inguinal hernias and direct hernias, with hiatal hernias being more common and direct hernias being rare. The general incidence of pediatric hernias is 1-4%, with the incidence in males being 12 times higher than that in females, with the right side being more common. It is higher in premature infants and may occur on both sides.
The best treatment for pediatric inguinal hernia is surgery. The timing of surgery is best performed after 6 months of age. However, if an incarcerated hernia occurs, surgery should be performed earlier to prevent repeated incarcerations with serious consequences.
There are two types of surgical treatment in our hospital, conventional open surgery and minimally invasive laparoscopic surgery. Pediatric prepuce The prepuce is a condition in which the foreskin and its opening in the male genital organs are so small that the glans is encased in the foreskin and cannot be turned out during erection. The prepuce is divided into congenital prepuce and acquired prepuce. When the mild epithelial adhesions between the inner plate of the foreskin and the surface of the head of the penis are absorbed, the foreskin recedes and the head of the penis is exposed. If the adhesions are not absorbed, congenital prepuce is formed. Acquired prepuce is mostly secondary to inflammation of the foreskin of the penis head, which causes scar contracture of the foreskin opening. If the prepuce is serious, it can cause difficulty in urination or even urinary retention. When the foreskin scale accumulates, there can be itching sensation on the head of the penis. Long-term chronic irritation can induce infection and cancer, leukoplakia and stones.
For congenital prepuce in infancy and early childhood, parents can perform cleaning care at home. First, the foreskin is repeatedly turned up to expand the foreskin mouth, this process should be gentle, and each time should be appropriate to stop, so as not to cause pain to the child. When the head of the penis is exposed, then clean the foreskin scale, and then restore the foreskin, otherwise it will cause embedded prepuce. For circumcision how to treat good results, patients such as the foreskin mouth is very tight, can not be turned up or acquired circumcision, should be circumcised. The surgery should be performed at the age of 5-6, because at this time it can be seen if the foreskin can recede on its own. In addition, there is the problem of going to school. After going to school, you can usually only come for surgery during holidays, and the time constraint may sometimes delay the condition. If you have recurrent infections, or if you already have scar formation, or if you have an ingrown prepuce, you are not bound by age.
Our current treatment is mainly outpatient surgery, using circumcision, which is short, painless, and the collar falls off on its own after surgery, without the need to remove stitches. Children younger than 6 years old who do not cooperate need to be hospitalized for surgical treatment under basic anesthesia. It is recommended that school-age children undergo the procedure during the winter and summer holidays. Outpatient surgery requires an appointment. Pediatric constipation Pediatric constipation is caused by a change in bowel pattern, which refers to a significant decrease in the number of bowel movements, dry, hard, constipated stools, long intervals between bowel movements (>2 days), irregularity, or the inability to pass stool despite having the urge to do so. Pediatric constipation can be divided into two categories: functional constipation and organic constipation. The vast majority are functional constipation. The fundamental treatment of functional constipation should be based on improving the content of the diet, adding more water and foods containing more fiber, and developing bowel habits. If there is fecal impaction, it should be treated by enema, oral laxative, etc. In case of organic constipation, the primary disease (e.g. congenital megacolon and megacolon like margin disease, anal stenosis, hypothyroidism, etc.) needs to be actively treated.