What is a hiatal hernia?
Inguinal hernia, also known as “hernia”.
The symptoms of an inguinal hernia are mainly a reversible mass in the inguinal region, commonly referred to as the root of the penis in an oblique upward position. This condition is usually seen in children under one year of age, and in some cases from birth. At first, the lump is small and appears only when the child stands, runs, coughs or cries. At night, when the child sleeps quietly and lies flat or when the lump is lightly pressed by hand, the lump can retract on its own and the symptoms disappear. It is more common in male children.
Is there any discomfort for children?
There is usually no special discomfort, only occasional localized swelling and involvement pain. As the disease progresses, the mass may gradually increase in size and descend from the groin into the scrotum or labia majora.
How can such a disease occur?
It is important to know that when your baby is still inside your belly, the male testicles are not in the present scrotum, but in the posterior abdominal wall area. From the 5th to the 28th week, under the testicular lead and hormonal stimulation in the body, the testicles, together with the peritoneum, gradually move down into the scrotum. This descending part of the peritoneum resembles a trumpet-shaped tubular protrusion with the mouth facing upward, called the peritoneal “sheath”.
This protrusion occludes itself during the late fetal period or within one month after birth. If the peritoneal sheath does not close in time due to genetic or premature reasons, intestinal organs such as intestinal tubes can gradually herniate outward along the open sheath, forming an inguinal hernia. From congenital causes alone, there are no strong measures to prevent the development of inguinal hernia. The incidence is about 1:50 in boys and 1:500 in girls.
Wow! Can it be contagious?
It is a congenital disease that occurs in small children and is not contagious. Adults also have “hernias”, but they are caused by weak muscles in the abdominal wall, and the cause is different, but also not contagious.
Is it dangerous?
Strictly speaking, there is some danger; in normal times, the mass appears and may disappear when sleeping quietly or when pushed by hand; however, there is a case of “incarcerated hernia”, which means that the protruding mass may suddenly increase in size and be accompanied by significant pain when the child suddenly coughs, cries or is uncomfortable. The mass cannot be retracted by lying down or by pushing it with the hand. The mass is tense and hard, and there is significant tenderness. The child cries more, which further aggravates the impaction, and a vicious cycle occurs.
If the embedded content is large omentum, the local pain is often mild; if it is intestinal collaterals, not only the local pain is obvious, but also the symptoms of mechanical intestinal obstruction such as paroxysmal abdominal cramps, nausea, vomiting, constipation and abdominal distension. Once the hernia is embedded, there is less chance of self-retraction; the symptoms of most patients gradually worsen and will eventually become strangulated hernia if not treated in time. In other words, the embedded object, intestinal tube or omentum, becomes necrotic. Then it is more troublesome.
Think about it, the intestine necrosis off, can it not be serious?
If you leave it alone, will it heal on its own?
It is possible. Theoretically, it is possible for the sphincter to close on its own and the hiatal hernia to heal on its own within one year of age. However, if the protruding mass is large and it gets embedded from time to time, the chances of self-healing are not very good. After one year of age, it is rare for the hernia to disappear on its own.
Is there any medicine?
No. ……
However, the practical point is, when the child is crying a lot, use your hand to gently press the protruding location of the lump to prevent it from protruding, the effect is also good, at least, will not let the lump protrude too much to.
There is no other way, the mass is always stuck there?
In this case, surgery is the only option. The frequent occurrence of intussusception can cause edema and thickening of the hernia sac wall, making future surgery more difficult. This makes the chances of recurrence after surgery even higher. If the intussusception occurs, the intestinal canal becomes necrotic and the intestine has to be removed, there are even more possible complications. The heartache of a small child may cause even worse results.
It is too dangerous to operate on a small child?
At present, surgical techniques and anesthesia techniques are constantly advancing, and this surgery is only a minor surgery. For the technical level, it’s not even a question of whether it’s dangerous or not. If it is necessary, it must be handled surgically. The surgery is also a relatively minor surgery. Remember, the fact that a child is “too small” is not a reason not to have surgery. If it is necessary, it must be treated.
How is it done?
The traditional surgery usually involves making a small incision, about 1-2 cm long, in the groin area to find the hernia sac and ligating it at a high level. The surgical procedure is relatively simple and the time is estimated to be around half an hour.
Minimally invasive surgery means laparoscopic surgery. The procedure is usually performed under general anesthesia by placing a laparoscope (0.5 cm) in size through the umbilical hole and then a puncture needle in the side of the abdomen, which ties the root of the hernia inside the “belly”.
Both have their advantages and disadvantages. Minimally invasive surgery means that the wound is smaller, because even the largest puncture point located in the umbilicus is 0.5 cm, which is not visible. Moreover, since the operation is performed inside the “belly”, both sides of the groin can be seen at the same time, and if a “hernia” is found on the opposite side, then the operation is performed at the same time to avoid the reappearance of a “hernia” on the opposite side in the future. “(This is something that traditional open surgery can never do, because it is impossible to open a knife for no reason), but the cost of minimally invasive surgery will increase by about $1,000 because of the laparoscopic system.
When is the best time to have surgery?
Usually around the age of 1 year. A detailed and comprehensive medical examination must be done before practicing surgical treatment. If there are manifestations of cold such as fever, cough, runny nose, etc., the surgery is not advisable to ensure the safety of anesthesia and surgery. After all, this kind of surgery is not an urgent necessity. It is better to be safe. Better, if a child has dry stools, it is recommended to do it after conditioning to avoid excessive postoperative abdominal pressure for defecation and increased chances of recurrence.
What do I need to do before surgery?
Before surgery. Of course, the physician must first look at the patient to confirm the diagnosis of inguinal hernia, and in some cases, ultrasound examination is necessary.
Then, admission to the hospital is arranged and pre-operative tests are performed. If there are no contraindications to surgery, surgery will be scheduled.
The procedure is also relatively quick.
My child is very fussy, can he or she have surgery?
It is true that small children are more fussy nowadays, but the pain is not obvious after the surgery. However, during the hospital stay, the child may have mood swings and cry due to changes in the environment, so parents need to cooperate.
What should I pay attention to after surgery?
The following are some of the things to pay attention to.
1, to understand the temperature change, because a few children after surgery will appear 1-3 days or so of low fever, generally below 38 .5 degrees, give with water, body wipe can solve the problem.
2, pay attention to avoid excessive crying, so, within one month after surgery, try to avoid this situation in small children; at the same time, avoid strenuous exercise, running, etc.; because these may increase the chances of recurrence.
3, the wound generally heals basically in about 5 days. You can take a bath, but avoid swabbing the wound to avoid cracking.
All the above information is given by Dr. Hong as a summary of the actual situation of the individual and is not used as a guide for treatment.
Medical condition varies from person to person, please refer to the doctor’s opinion.