I. What is the difference between pediatric hernia and middle-aged and elderly people?
A hernia is when a part of the body tissue or organ leaves its original part and enters another part through an interstitial, defective or weak part of the body. The main difference between pediatric hernia and middle-aged and elderly people is that pediatric hernia is caused by congenital end closure of the sphincter and the inguinal canal in children is short (about 1-2 cm), so pediatric hernia can be easily operated by simple high ligation of the hernia sac through the external ring opening. In contrast, in middle-aged and elderly people, most of the hernias are caused by weakness of the abdominal wall, so in addition to “high ligation of the hernia sac”, “hernia repair” is also performed, which is a relatively complicated operation.
What are the complications of pediatric hernia?
Complications of pediatric hernia are mainly intestinal necrosis, intestinal obstruction and peritonitis caused by hernia entrapment, and in girls, hernia may lead to sterility once necrosis occurs because the entrapment may be attached to the ovary.
Why do hernias mostly occur in the abdomen?
Because the abdomen has more tissue gaps, defects or weaknesses compared to other parts of the body.
What kind of hernias are direct hernia, hiatal hernia, femoral hernia, umbilical hernia, white line hernia, incarcerated hernia, strangulated hernia and incisional hernia?
A straight hernia is an inguinal hernia that protrudes from the medial aspect of the inferior abdominal wall artery through the inguinal triangle. Its incidence is lower than that of hiatal hernia, accounting for about 5% of inguinal hernias, mostly in elderly men.
Inguinal hernia refers to the protrusion of intra-abdominal organs or tissues through the inguinal canal, accounting for about 90% of inguinal hernias and is the most common type of extra-abdominal hernia.
Femoral hernia refers to the protrusion of organs or tissues into the femoral canal through the femoral ring and then protrusion of the oval fossa through the femoral canal as a femoral hernia. A hernia in which the hernia sac protrudes through the femoral ring and into the fossa ovalis via the femoral canal.
Umbilical hernia is a hernia that protrudes through the umbilical ring.
White line hernia, also known as supra-abdominal hernia is a hernia protruding through the white line of the abdomen.
An incarcerated hernia is a hernia in which the contents of the hernia pass through the neck of the hernia and then the muscles of the neck of the hernia tighten due to various factors, causing near blockage of the muscular channels of the abdominal wall, so that the herniated intestine is stuck in the neck of the hernia and cannot be returned to the abdominal cavity.
Strangulated hernia is the most severe type of hernia and develops from an incarcerated hernia. In an incarcerated hernia, the hernia contents are not returned in time and the hernia ring is stimulated by the hernia contents and contracted with tension, while the hernia contents are further compressed at the hernia ring. As the compression of the hernia contents at the hernia ring increases, the arterial blood supply decreases or even stops, and the hernia develops into a strangulated hernia, with ischemic necrosis, perforation, peritonitis, and intestinal fistula occurring in succession.
Incisional hernia is a hernia of intra-abdominal organs or tissues protruding from the abdominal incision is a common complication of cesarean surgery, mostly occurring in the longitudinal abdominal incision area, seen in incisional dehiscence, infection, second-stage healing incision few occur after a longer period of time without a history of incisional dehiscence but appearing after surgery.
V. Is traditional surgery for pediatric hernia better or minimally invasive?
The advantages of traditional surgery (extraperitoneal operation) are: short time (10-20 minutes), shallow anesthesia, cost saving, and surgical incision of about 1 cm.
The advantages of minimally invasive surgery (laparoscopic operation) are that the treatment of ipsilateral hernia is accompanied by observation of the other side of the hernia, the surgical incision is around 0.5cm, and there is no obvious scar after surgery, but the anesthesia is relatively more complicated and the cost is higher.
Therefore, the indications for minimally invasive treatment in our department are left-sided hiatal hernia, giant hernia, recurrent hernia and those with special requests from parents.
VI. What is the cure rate of pediatric hernia?
The cure rate of pediatric hernia treated by surgery is nearly 99%, and there is a recurrence rate of about 1%.
What is physical therapy for pediatric hernia?
The most common is the hernia belt, but in clinical practice, it is found to have little or no effect on the treatment of hernia.
Can medication or diet modification treat pediatric hernia?
No. The reason is that the hernia sac in children is as large as a hernia sac. Because the hernia sac of a child is like a pocket, the only way to prevent the protrusion of the hernia contents is to tighten the pocket. Medicine or diet adjustment will not do this.
What supplements should I take for a pediatric hernia?
There is no need to take supplements, just eat a normal diet and keep the bowels open.
What are the hazards of pediatric hernia?
1. it may cause intestinal necrosis due to entrapment. 2. long-term protrusion of hiatal hernia may cause pressure on the vas deferens and may affect the quality of sperm. 3. long-term recurrent protrusion will increase the pain of the child and bring great psychological burden to the parents.
What are the sequelae of pediatric hernia after surgery?
For professional surgeons, there are no sequelae after surgery.
Is there anything to note about pediatric hernia?
1.Keep the bowel movement smooth and avoid crying and strenuous movement of children.
2. If the local hernia does not disappear for a long time and is accompanied by pain and vomiting, it means that the hernia has become ingrown and it is recommended to go to the hospital as soon as possible to reply.
3. For pediatric hernia that is repeatedly embedded, early surgery is recommended.