Pediatric hernia is one of the common diseases in pediatric surgery. It is known that the incidence of pediatric hernia is generally around 1-4%, and babies under the age of 1 are most likely to develop the disease due to incomplete development of the anatomy. However, some parents are not sure if their baby has the disease. If your baby is crying for no reason or refusing to eat, parents should check to see if your baby has a hernia that has become ingrown.
What exactly is a pediatric hernia?
Rui Rui is a newborn baby of two months old. One time when his mother was bathing him, she overheard that when he cried, a bag would bulge in his groin, but when he was lying in bed or not crying, the bag disappeared again. After a while, the pouch ran into the scrotum again. The child was taken to the hospital, and later on, after examination, the bag was a “pediatric hernia”.
”The main medical term for pediatric hernia is inguinal hernia and umbilical hernia, of which inguinal hernia is the most common. A hernia is a condition in which an organ in the abdominal cavity is dislodged from its normal anatomical site or enters another site through a congenitally existing or acquired weak point or defect. In simple terms, it means that an organ in the stomach has gone elsewhere. The small pouch on the baby’s belly button or thigh is a “hernia.” The contents of the hernia are aggravated by the increased intra-abdominal pressure, and when the baby cries, the abdominal pressure is increased, so the pouch bulges out even more. When lying down or not crying, the pouch will temporarily disappear.
”Pediatric hernia is mainly caused by increased intra-abdominal pressure, including internal and external factors. Internal factors are congenital weaknesses or defects, like the umbilical cord of a newborn child will form a scar if it is not cut properly. In addition, external factors such as constipation, urinary urgency, and chronic cough can cause increased intra-abdominal pressure.”
Babies under 1 year old are most likely to develop
Babies under 1 year of age are most likely to develop pediatric hernia because their anatomy is not fully developed, and the incidence is usually around 1-4%. Inguinal hernia is a fairly common pediatric condition and is seen overwhelmingly in male patients, far more often than females.
Some parents ask whether a male baby with a hernia on one side of the groin will also have one on the other side. As the testes descend to the scrotum during male development, the incidental formation of the peritoneal sphincter, if not occluded in time, will form a weak point and lay a hidden danger for the formation of a hernia. Both sides occur.
How can parents find out if their child has a hernia?
It is not uncommon for pediatric hernias to cause intussusception, intestinal obstruction, necrosis, and even death in children. Then parents should observe their babies carefully and pay close attention to the following signs if they occur.
When the child is crying, parents should check the child’s body carefully to see if there is a round or oval-shaped protrusion at the umbilicus or the root of the thigh, which becomes more obvious and increases in size when standing upright or coughing, etc. In addition, the protrusion can be completely incorporated into the abdominal cavity when lying down and reappear when standing upright or coughing; if the above symptoms are present, the child is likely to have a hernia and needs to be diagnosed and treated in time.
If the child has severe vomiting, fever, bloody stool and intestinal obstruction, or recurrent crying for unknown reasons, it is necessary to consider the possibility of pediatric hernia with intussusception.
Surgical treatment is the only way to cure pediatric hernia
Every parent can’t bear to subject their child to the pain of “opening an incision”, so many parents of babies with hernia seek other means than surgery, and “hernia belts”, which are advertised as painless and non-invasive, are very popular. The hernia belt is not as effective as advertised, it has some effect but it is not a cure.
The need for surgical treatment of hernia The hernia belt can only provide temporary relief
Some parents are reluctant to let their children undergo surgery and prefer to buy hernia belts or give them medicine, thinking that this will also make the hernia disappear or become smaller, which is actually just wishful thinking. Because a hernia is a physical defect in the abdominal wall that cannot be cured by any medicine, a hernia belt can only temporarily relieve symptoms and prevent ingrowth, but cannot cure a hernia.
”Some patients with heart disease, stroke and other poor systemic conditions, who are temporarily unfit for surgery, or children with frequent coughs and lung infections, can use hernia belts temporarily, preferably under the guidance of a doctor, and undergo surgery when their condition is stable or when they are fit for surgery.” The hernia belt only brings back the protruding hernia sac using the principle of compression, but the weak anatomical structure that really causes the hernia is not solved. Although the patient’s symptoms improve for a while, the hernia will still exist once the abdominal pressure is increased by strenuous exercise, coughing and forceful defecation, etc., and it may lead to hernias embedded in the contents and cause necrosis due to the repeated entry and exit of the hernia contents. Therefore, the treatment of hernia can only rely on surgical treatment to cure the symptoms.
Minimally invasive surgery is not recommended for children, and general surgery is sufficient.
If the child is not suitable for surgery, he or she can undergo conservative treatment or expectant treatment. During the expectant treatment period, parents should pay attention to observation and look for protrusions from the belly button and groin when bathing the child. However, very few can be cured by conservative treatment (hernia belt, hernia patch).
Surgical treatment is the only radical treatment that is not prone to recurrence. Surgical treatment is a symptomatic treatment to repair the cause of the disease, eliminating the weak points and defects that existed at birth or formed later in life, so that hernia will not occur naturally after the cause of hernia development is eliminated. However, the surgical operation may cause damage to the adjacent tissues and affect the development of the genitourinary system. Minimally invasive surgery is not advocated for pediatric hernias, and minimally invasive can be used for adult hernias. Pediatric inguinal hernia can be discharged from the hospital the next day after surgery as long as a high ligation of the hernia sac is done, and the cost is about 3000 to 4000 RMB. The incision of the high ligation of the hernia sac is only 1.5 centimeters, which causes minimal damage and effectively avoids postoperative complications.
What do I know about precautions before and after surgery?
Before surgery, children should avoid and reduce crying, coughing and strenuous exercise as much as possible; pay attention to resting flat on the back at the right time; and also increase nutrition appropriately to strengthen physical fitness.
After surgery, the following care should be paid attention to.
1, to avoid colds, pay attention to the protection of the wound, to keep the wound clean, to prevent children from contaminating the wound causing infection, septicemia, etc.;
2, after surgery, there may be different degrees of scrotal swelling, generally 3 days will subside, if the swelling does not eliminate suggests that there is bruising, please ask the doctor to check and do the corresponding treatment;
3.After the anesthesia, the child may cry because of pain, so avoid crying;
4.After the operation, please pay attention to let the child sleep on his or her side to prevent pressure on the wound, so that urine will not contaminate the wound once the bed is wet.