What is the nature of an inguinal hernia?

An inguinal hernia is the exit of tissue or an organ (a strand of omentum, a loop of intestine, an ovary, etc.) from the abdominal cavity through a wide inguinal canal. When the hernial contents descend into the scrotum, the hernia is called an inguinoscrotal or complete hernia.

What are the features of inguinal hernia in children?

In children, in most cases, indirect inguinal hernias occur. They have a common nature with communicating hydrocele and spermatic cord cyst and can be combined with them. Hernial sac - the container for hernial contents is the wide vaginal process of the peritoneum - a protrusion of the peritoneum that forms in utero.

An inguinal hernia occurs in 1–3% of children, more often in boys. In most cases it is noted on the right. In 1/3 of cases, a hernia appears during the first 6 months of life. Bilateral inguinal hernias are common. Inguinal hernias heal spontaneously in only 1:20-40 children.

Typically, indirect hernias appear in children in the first 2 years of life, often when the child is crying, restless, or lifting heavy objects. Unlike Newborn boy: risk zone and spermatic cord cysts, an inguinal hernia can be strangulated and requires urgent treatment.

Rarely in childhood, a direct inguinal hernia occurs, similar to inguinal hernias in adults.

How does an inguinal hernia manifest itself?

An inguinal hernia manifests itself as a swelling in the inguinal or inguinal-scrotal area, which increases with activity and restlessness of the child. When you press on this tumor-like formation, it disappears - the hernia is “reduced.”

The spread of swelling to the corresponding half of the scrotum may indicate the presence of an inguinoscrotal hernia or testicular hydrocele.

In many cases, parents themselves may suspect an inguinal hernia and confirm their fears when visiting a doctor.

If swelling appears in the groin area, you should immediately consult a specialist in order to diagnose the hernia in time and distinguish it from a spermatic cord cyst and hydrocele. In doubtful cases, it is advisable to perform an ultrasound examination of the scrotum and inguinal canals (ultrasound).

What happens when an inguinal hernia is strangulated?

Often, a loop of intestine gets into the hernial sac, which can become pinched in the inguinal canal. In this case, the venous outflow in the intestinal loop is disrupted, edema occurs, which impedes arterial circulation (strangulation), which ultimately leads to necrosis (necrosis) of the intestinal wall, perforation and peritonitis.

In girls, the hernial contents when strangulated often turn out to be the ovary with the fallopian tube, which can lead to necrosis of part or all of the ovary or necrosis of the fallopian tube. In this case, reduction is often unsuccessful and emergency surgery is required.

A strangulated inguinal hernia is a surgical emergency. If a strangulated hernia is operated on early, the cure is complete. Delayed treatment of a strangulated inguinal hernia can lead to severe complications and even death.

How urgent is surgery for an inguinal hernia?

The issue of timing of surgical treatment is decided individually. As a rule, surgery is scheduled as soon as possible after diagnosis. In case of a strangulated inguinal hernia, it is necessary to reduce it early after the strangulation, and if this is not possible, surgery must be done within 6 hours after the strangulation.

How is anesthesia administered?

We use combined options for pain relief using sedatives and local anesthesia, which allows us to sharply reduce the concentration of drugs used for anesthesia and ensure the absence of mental trauma and good pain relief in the postoperative period. For general anesthesia we use the latest inhalation anesthetic servoflurane (quick recovery from anesthesia)

What is the essence of hernia repair surgery?

Hernia repair operations in the clinic are performed on the day the child is admitted. The main purpose of the operation is to remove and suturing the hernial sac, repositioning the organs into the abdominal cavity, and restoring the normal anatomy of the inguinal canal. Given the close connection of the hernial sac with the vas deferens and elements of the spermatic cord, in boys these operations require delicate technique and special skills of the surgeon.

What complications occur after surgery?

Incorrectly performed surgery can lead to relapse of the disease or infertility. Complications of herniotomy include high fixation of the testicle, lymphocele, lymphostasis in the testicle and testicular membranes.

How do children cope with hernia repair operations?

Hernia repair surgery is not difficult for a child. Discharge is usually made on the day of the operation. Bed rest is recommended for three days, home rest for 10-14 days, laxatives for 3-4 days. Sutures are removed upon examination on the 7th day.

An inguinal hernia is a condition in which the hernial sac protrudes through the peritoneum. Inside the sac are internal organs, so their location changes and their functions deteriorate.

Now let's look at this in more detail.

What is an “inguinal hernia”?

A hernia can occur in different areas; when localized in the groin, the bladder and intestines usually come out. This happens through the inguinal gap, which is located between the muscles and ligaments. In girls, the hernial sac may also include the ligament of the uterus, and in boys, the spermatic cord.

Pathology can be congenital or acquired. It often occurs in premature babies. The protrusion itself may be painless, but during physical activity pain is felt and symptoms of disturbances in the functioning of internal organs arise.

Complete removal of a hernia is only possible through surgery, which is recommended for children whose pathology is visible from birth. Often the disease is combined with others - hydrocele, hip dysplasia, spinal abnormalities. The problem occurs several times more often in boys than in girls. This is explained by the peculiarities of intrauterine development, during which a canal is formed for the descent of the testicles into the groin area. Normally, the hole should close; if this does not happen, an inguinal hernia occurs. Clinical manifestations are not always immediately noticeable and may appear throughout the child's life.

The danger of the disease is that during physical activity the hernia may be strangulated, after which the internal organs cannot be reset into the peritoneum on their own. This leads to their dysfunction and the appearance of additional symptoms.

What does an inguinal hernia look like in children with photos

The degree of protrusion during a hernia can vary. It is often invisible when lying down and appears only when the abdominal muscles tense, for example, when a child cries or laughs. In boys, the hernia looks like hydrocele, in girls it has a more characteristic appearance. Examples of inguinal hernia are shown in the photo below:

The first signs of an inguinal hernia

Congenital inguinal hernias are noticeable immediately after birth. The first sign is protrusion of the skin in the form of swelling. It is painless, has a round shape and can completely disappear when the child is calm. If the hernia is large, it is not difficult to notice it; if it is small, it is detected a little later, when the child begins to become active or cry.

Hernias can be right-sided or left-sided. In some cases, pathological protrusion forms on both sides. In addition, oblique and straight formations are distinguished, and several types are distinguished, depending on the degree of mobility, which is important for the doctor.

Symptoms of inguinal hernia

The swelling itself is painless, however, during the movement of organs through the hernial gap and back, the child may experience discomfort. Some complain of nagging pain, others complain of a feeling of heaviness in the lower abdomen.

In boys, a hernia leads to stretching and asymmetry of the testicles. At the location of the hernia, the scrotum will be enlarged. In girls, a similar thing is observed with the labia - one of them will be clearly larger. The hernial protrusion does not always descend into the genitals, but may remain in the lower region of the peritoneum. In this case, the swollen ball will be visible much better. Most often, the protrusion occurs on the right side.

Organs trapped in the hernial sac can be compressed when moving. This leads to strangulation of the hernia and closure of organs on the outside of the peritoneum. This condition is accompanied by poor circulation, increased intra-abdominal pressure, flatulence, and pain.

When pinching occurs, the child begins to cry sharply, becomes restless and complains of pain. The bulging area cannot go back down and becomes hard, tight and painful. Almost always, the intestine gets into the hernial sac, so its strangulation leads to intestinal obstruction. As a result, the child develops bloating, an inflammatory process develops, and later necrosis of the organ walls. In the absence of urgent help, there is a possibility of perforation of the intestinal wall and the development of peritonitis.

The disruption of blood supply that occurs during strangulation is especially dangerous for girls. Insufficient nutrition of the tissues of the ovary and genital organs leads to the death of eggs and necrotic processes.

Causes and prevention of inguinal hernia

In children, inguinal hernias are predominantly a congenital feature. At the stage of fetal formation, the child has a vaginal process, which at the 12th week of development resembles a protrusion. After performing its functions, the appendage overgrows, and disruptions in this process lead to the formation of cracks and the appearance of a hernia after birth. Premature babies are more likely to develop a hernia because the area does not have time to heal. This appendix is ​​the hernial sac into which the internal organs enter: in girls - the intestines, ovary and fallopian tube, in boys - the intestines, spermatic cords.

It is believed that the disease can be inherited. Approximately 11% of children with an inguinal hernia had a relative with a similar pathology.

It is widely believed that a hernia can be acquired if the child carries heavy objects or cries too much. In fact, this happens very rarely. Basically, acquired pathologies can occur in boys of school or puberty age who engage in intense physical activity and at the same time have congenital weakness of the abdominal wall.

Thus, an inguinal hernia forms even before the birth of a child, but the pathology can increase in size during intense physical activity, which is why many consider the hernia to be acquired.

Of the provoking factors that lead to protrusion of the hernial sac, doctors identify the following:

• cystic formations in the ovaries or spermatic cords;
• hip dysplasia;
• problems with the spine;
• obesity;
• constipation;
• severe cough.

Prevention of hernia includes timely detection of pathology and regular visits to specialists to monitor the dynamics of hernia development. Children are advised to exclude the provoking factors described above, and then the number of protrusions and pinching will be significantly less.

To prevent acquired hernia, it is recommended to take care of the general health of the child. This includes moderate physical activity, which will help strengthen the abdominal muscles, treatment of constipation, as well as proper nutrition to normalize the functioning of the gastrointestinal tract.

Diagnostics

Typically, a hernia is diagnosed immediately after the baby is born. The pathological protrusion is noticed by the parents themselves or discovered by the doctor during a routine examination of the baby. To make an accurate diagnosis, the results of instrumental studies, visual examination and palpation, as well as anamnesis will be required.

To make it easier to identify a hernia, the child is asked to bend over, strain or cough. When the abdominal muscles tense, the protrusion becomes more noticeable. After this, the child is asked to take a horizontal position. With an uncomplicated hernia, the internal organs are easily reduced into place. If the intestine gets into the hernial sac, then as it moves from the peritoneum and back, characteristic rumbling sounds can be heard.

After a preliminary diagnosis, the doctor sends the child for an ultrasound. An ultrasound examination examines the pelvis, inguinal canals and peritoneum.

The specialist must also differentiate an inguinal hernia from other diseases that have a similar appearance (inguinal hernia, femoral hernia, spermatic cord cyst).

Treatment of inguinal hernia

Only unstrangulated hernias can be set back. If the organs are nevertheless pinched, the pathology can only be corrected by surgical intervention. The quality of the result depends on the degree of neglect of the process and the stage at which treatment begins. Conservative therapy is theoretically possible, but is not currently used. It involves constantly wearing bandages or compression garments, which will prevent the organs from protruding outward.

For young children, surgery is performed at the age of 6-12 months. The procedure involves cutting off the hernial sac and restoring the normal anatomy of the inguinal canal. This may also require strengthening the affected area with your own tissue.

Surgical treatment can be performed openly and using laparoscopy. The second technique is preferable, as it has fewer side effects and requires minimal tissue incisions. When performing the procedure, the surgeon must be careful not to damage the spermatic cords, otherwise this will disrupt reproductive function.

The operation is performed by a doctor in a hospital setting and if the outcome is successful, the child can be transferred to home treatment.

If a girl's hernia is strangulated, emergency surgical intervention is indicated, since there is a high probability of ovarian atrophy and impaired reproductive function. If a hernia is strangulated in boys, measures can be taken to independently reduce the organs:

• take a warm bath;
• take antispasmodics to relax muscles and widen the hernial gap;
• position the child horizontally or lift his pelvis upward to make it easier for the organs to “return.”

The prognosis for a child with an inguinal hernia is, in most cases, favorable. For uncomplicated conditions, surgical treatment is very effective. Before surgical reduction of strangulated hernias, it is necessary to first ensure the viability of the organs. If their blood supply has been severely impaired and necrotic areas have appeared, the doctor performs a resection.

Complications

A complication is considered to be a pinched inguinal hernia and the consequences that this condition leads to. It is impossible to predict pinching in advance. It is a jamming of internal organs between the muscles of the peritoneum, so that they are sticking out. In this case, the muscles often spasm, which makes it impossible to return the contents of the peritoneum back. This often occurs when the intestinal loop is overcrowded, which gets into the hernial sac and falls out after physical exertion.

If a child is pinched, immediate surgical assistance is required. The process is acute and occurs suddenly. The child suddenly experiences severe pain in the groin, feels nausea and attacks. The area of ​​the hernia that sticks out becomes hard and irreducible. The patient's health deteriorates sharply and quickly.

In addition to painful sensations, pinching is dangerous because it interferes with normal blood flow in organs that are outside the peritoneum. Within a few minutes, tissue appears in them, and after a few hours necrotic processes develop. In 10% of cases when pinched, doctors diagnose gangrene. Such conditions are life-threatening for the child and can be fatal if timely assistance is not provided.

If parents are offered to undergo surgery to remove a hernia while the child is still small, they should agree. As you get older, the likelihood of getting pinched will increase. In addition, the baby will have to limit himself in many ways in everyday life until he gets rid of the problem. An inguinal hernia does not go away on its own and in any case will have to be removed at some age.

Rehabilitation

After surgery, the child is recommended to rest for the first time so that the functioning of the internal organs is restored and returns to normal. After about a month, doctors say to do special physical therapy exercises to strengthen the muscles of the abdominal wall and accelerate tissue regeneration.

It is recommended to add breathing exercises to special physical exercises, which improves homeostasis and the child’s overall immunity. Already a month after surgery, the doctor may allow you to visit the pool or engage in active walking.

It is very useful to attend massage sessions. Their goal is not only to strengthen the abdominal muscles, but also to normalize intestinal motility. Massage movements are performed in the navel, groin, oblique abdominal muscles, and also on the back along the spine.

Sometimes doctors recommend taking mild laxatives to avoid straining and straining the surgical area during bowel movements. Duphalac is an absolutely safe drug for children of any age. Postoperative bandages can be used as an aid. They need to be purchased in specialized places, taking into account the individual sizes of the child.

A hernia located in the groin occurs as a result of a defect in the formation of muscle or connective tissue. In adolescents and adults it can be acquired, but in children under ten years of age it can only be congenital. Therefore, symptoms appear early and can threaten both the further development of the genital organs and the health of the intestines.

Inguinal hernia in boys is more common than in girls. Shortly before birth, the testicles make a long and complex journey down to the pelvic area. During this period, minor deviations in their movement may occur, which subsequently turn into serious functional defects. Girls' genitals also change their location - just not so radically. That is why the hernia is observed in them too, only less often.

Reasons for boys

Immediately after conception, the testes in boys are not located in the scrotum, but in the lower part of the abdominal cavity. And they descend into the scrotum later - by the third trimester of pregnancy. They go down there along with a section of the peritoneum, which, as it were, sticks around the testes, forming their shell. Since the testes and testicles are embedded in this peritoneal pouch, it is called the processus vaginalis of the peritoneum. Subsequently, this through channel between the scrotum and the abdominal cavity is closed, isolating them from each other.

When complete fusion does not occur, the boy develops one- or two-sided hydrocele of the testicles or a scrotal hernia. It depends on the size of the “hole” and its location. If it is small, clear fluid from the abdominal cavity (dropsy) simply begins to accumulate in the scrotum. If it is large, intestinal loops fall into it (hernia).

Reasons for girls

In girls, the origin of the inguinal hernia is somewhat different. Their uterus is also initially located in relation to other abdominal organs a little higher than it will be in adulthood, and therefore descends into the pelvis as the body develops. But this displacement is not so significant, and it is ensured by the formation of several ligaments of the uterus - muscle and connective tissue “suspensions” that will hold it, preventing it from falling into the vagina, throughout the entire future life.

There are several uterine ligaments, and the prolapse of the pelvic organs is additionally prevented by the pelvic muscles. Despite this, insufficiency of at least one of them (most often we are talking about the round ligament of the uterus) can result in a girl prolapse into the hernial sac:

• intestinal loops;
• ovary.

And pregnancy, if such a defect persists in adulthood, will most likely end in prolapse of the entire uterus.

Risk factors

The most common cause of the development of an inguinal hernia in a child is prematurity, especially if it is more than a month old. But the following options are also possible:

• hereditary predisposition- the composition of the parents’ genes involves the transfer of many anatomical features and the structure of the pelvis to the child;
• abdominal injuries- including penetrating wounds, interventions for other reasons and lifting excessive weight, which often leads to muscle or ligament tears;
• malignant and benign processes- on the ligaments themselves or in the organs that they hold;
• underdevelopment for other reasons- among them may be chronic hunger or poor diet, hormonal imbalances (for example, caused by pathology of the adrenal glands or thyroid gland).

Unlike an inguinal hernia in boys, in girls such a defect has no chance of healing itself after a few months or years. It cannot be adjusted, at least not permanently. Therefore, if in the case of boys, pediatricians often advise parents to wait until the child is one and a half years old (by this age the defect may heal on its own), then an inguinal hernia in girls requires immediate treatment.

Signs

When prolapsed, the hernia is clearly visible in the form of a protrusion on the right or left above the pubis. Especially in moments:

• hysterical, prolonged crying, coughing, screaming;
• straining during bowel movements;
• standing and walking (if the child already knows how to do this).

In addition, if a child has a prolapsed intestinal loop, during this period he may experience:

• gases;
• rumbling in the stomach;
• belching of eaten food.

The loss of one of the ovaries in girls does not manifest itself subjectively in any way. Maximum - aching pain in the lower abdomen.

Differences from a tumor

The situation is more complicated with hernias that prolapse closer to the scrotum (in boys) or in the area of ​​the labia majora (in girls). Parents often confuse them with a tumor, since such a hernia makes one of the testicles or the labia majora visually thicker. But even in this case there are differences:

• the hernia periodically reduces itself - especially at first, since over time she loses this ability;
• a tumor is a static neoplasm - it cannot appear and disappear.

Suspicion of an inguinal hernia is confirmed by ultrasound of the abdominal cavity and pelvis.

Complications

In case of pinching of intestinal or ovarian loops protruding into the hernial sac, the matter may result in their necrosis. Acute strangulation of any organs is the most serious of the complications of a hernia, requiring urgent surgical intervention.

In children it manifests itself:

• cramping pain in the abdomen- because of them the child is restless, cries and screams;
• temperature rise- especially as swelling and necrotic processes in the tissues in the injured area increase;
• nausea and repeated vomiting- only if the intestines were strangulated.

Surgical treatment

Treatment boils down to excision of the hernial sac and surgical suturing of its edges. The operation may be postponed until the child reaches one and a half years of age, but:

• only in boys (self-fusion of tissues is possible);
• if she is not prone to acute injuries;
• if it is not accompanied by other defects of the abdominal wall (an inguinal hernia is often accompanied by an umbilical hernia).

Laparoscopic surgery

Removing an inguinal hernia in children under two years of age is always a big risk, especially with a routine opening of the abdominal cavity, which leads to damage to the abdominal muscles. Therefore, modern surgery increasingly gives preference to laparoscopy (laparoscopic hernioplasty).

With it, the surgeon “from the inside” excises the edges of the abdominal wall defect and sutures it, without making large incisions on the anterior surface of the abdomen. Access to the surgical site is carried out through several small (about a centimeter long) incisions. A set of tubes of the appropriate diameter is inserted into them, and with their help they are brought to the site of intervention:

• lighting fixture;
• wide-view, high-resolution video camera;
• instruments for hernia repair;
• air duct

A special gas mixture is supplied through the air duct into the abdominal cavity (to straighten the abdominal cavity and give the surgeon a view and room for manipulation).

This method of intervention allows you not to apply an aesthetically dubious visible suture after the operation. It is also important that it minimizes the level of trauma not only to the skin, but also to the abdominal muscles. This matters from several points of view.

• To speed up rehabilitation. The smaller the scale of direct and indirect injuries inflicted by the surgeon, the faster the body’s recovery will occur.
• To prevent relapses. If a child already has one, and even more so, more than one hernia, the risk of developing a new one due to wide and deep incisions made in the muscles nearby is extremely high.
• To prevent postoperative complications. Despite the sterility of the intervention, it cannot be complete in any case. And a large wound provides a wider opening for infection than several small incisions.

Laparoscopy is preferable to classical hernia repair methods. In this case, the technique for removing the hernia itself is standard, and the element of novelty is only in the method of accessing it.

Alternative medicine methods

You need to understand that in the case of an inguinal hernia, we are talking about the presence of a hole where there should not be one - about a “tear” in tissues that by nature should be solid. This kind of defects is not amenable to the action of medicinal plants, suggestion, or spells.

In addition, over time, the edges of the hernial opening, also called the hernial orifice, grow with hard cartilaginous tissue. This is their natural response to constant injury from prolapsed organs. Therefore, the surgeon is forced to first trim the edges to the “living” tissue, and only then sew them together.

Thus, all attempts to treat a hernia in a child with folk remedies, including partially effective ones (for example, massage for the next prolapse or strangulation) are doomed to failure in advance. It can only be treated by elimination that is the same physical as its origin. That is, with the help of completely material threads, a scalpel and, sometimes, mesh implants (a mesh made of material that is well compatible with body tissues, which ensures that its cells are overgrown with connective or muscle tissue and allows you to close even a large hernia).

The use of alternative methods only threatens the child with acute harm. This phenomenon is unpredictable, and it has only two possible outcomes - immediate surgery or death over the next few days due to necrosis of the strangulated area of ​​the organ. If a girl’s ovaries are pinched, death may occur earlier due to severe intra-abdominal bleeding.

Prevention

Prevention of inguinal hernias during fetal development is a complex topic. Many conditions during pregnancy cannot be avoided without putting the lives and health of both the mother and her baby at greater risk (for example, premature birth cannot be stopped). But it is possible to prevent risk factors after birth with a high chance of success. The key to the health of the muscular-ligamentous corset of the body is:

• properly organized physical development;
• avoiding injury.

To avoid an inguinal hernia in a child, it is necessary to protect him from lifting excessive weights. This mistake is more common among parents than is commonly thought, because in an effort to quickly turn their baby into their helper around the house, they may forget about the difference in the development of their own and their child’s muscles. Periods of physical activity in children should also be replaced by proper rest, since the ease with which the younger generation of the family can withstand its high pace is often apparent.

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How treat inguinal hernia in children and in what cases can you do without surgery? Today we will talk about what modern treatment of inguinal hernia in a child completely eliminates the problem and does not have a negative impact on the functioning of adjacent organs.
An inguinal hernia is a tumor that occurs in the groin area. If the formation has spread to the scrotum, the hernia becomes inguinal-scrotal. This tumor (hernial sac) contains the ovary, omental strand, intestinal loop, and other organs. If you press on the hernial sac, you can hear some kind of rumbling, then the formation disappears, and reduction occurs.
Often in children an indirect inguinal hernia is diagnosed. The disease occurs in the same way as a cyst of the spermatic cord or communicating ovarian hydrocele. The vaginal process of the peritoneum (wide, not closed) acts as a hernial sac, which connects the abdominal cavity and the scrotum. From the abdominal cavity, through a process, everything is discharged into the inguinal canal. Inguinal hernia in children- a fairly common disease nowadays and in most cases it is indicated surgery to remove hernial sac to avoid destruction of the structure of the inguinal canal under the pressure of a hernia that grows with age.

For a child, an inguinal hernia is a serious illness that must be treated. The use of traditional medicine recipes in most cases aggravates the problem. In babies, hernias are predominantly congenital, caused by weak muscle tissue on the front of the peritoneum. Doctors notice them immediately after the baby is born. Sometimes muscle weakness is caused by the baby’s prematurity; not all of its organs are sufficiently developed.

If an inguinal hernia is detected in a child You should immediately consult your pediatrician. After the examination, he will explain how to deal with the disease in a particular case.
An inguinal hernia is repaired using operations, which is performed on a small patient no earlier than six months. When exactly is decided by the pediatric surgeon.

But if a child’s inguinal hernia is strangulated, then it should be repaired immediately. If this is difficult to perform, urgent surgical intervention is indicated (within 6 hours from the moment of injury).

Herniotomy is performed on the baby on the day he goes to the hospital. During the operation, the surgeon removes (sutured) the hernial sac, realigns the displaced organs, returning the inguinal canal to its normal structure. The spermatic cord and vas deferens are partially connected to the hernial sac; it is necessary to operate on a male patient very carefully.

An umbilical hernia is almost never strangulated; here it is often possible to do without surgical intervention. Girls are operated on if the umbilical ring is dilated. Bloodless operations, without incisions, are now becoming popular. Children tolerate them well, do not feel severe pain and do not encounter complications. Mom during surgery next to her child. The body recovers quickly, and after a couple of hours you can return home.

It is important to keep in mind that inguinal hernia in children is a very dangerous disease and if you detect obvious symptoms of an inguinal hernia in your child, you should seek qualified help from a pediatric surgeon as soon as possible. Only a specialist should decide what treatment the baby needs. In some cases, it is enough to perform a reduction (at an early stage of hernia formation). But in most cases, surgery is indicated to restore the anatomy of the abdominal canal as quickly as possible and remove the hernial sac.

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Many young parents are faced with the problem of inguinal hernia in children. Despite the fact that this diagnosis is very common, most people do not understand the essence of this disease.

The search for information about the causes, consequences and the need for surgery usually begins when the problem is already making itself felt. The most dangerous thing is the delay of parents in diagnosing and treating this disease, because complications of an inguinal hernia can seriously affect the baby’s health.

What is an inguinal hernia

An inguinal hernia occurs when part of the abdominal organs (omentum, intestines, and, in girls, the genitals) sag into the groin area.

The formation itself consists of three parts: the hernial sac (protrusion shell), the internal contents of the hernia and the hernial orifice through which the organs protrude.

The size of the hernia can vary and depends on how much internal organs have moved outside the abdominal cavity. In some children this is a small swelling in the groin area, in others it is a very large, voluminous protrusion, which is simply impossible not to pay attention to.

With increased effort, when the child coughs, sneezes, cries or lifts heavy objects, the hernia becomes more noticeable and bulging. At rest, it can even come into place spontaneously or with manual reduction (reducible hernia).

In more advanced cases, the contents of the hernial sac do not return to place (irreducible hernia). The most dangerous situation occurs if the hernia is strangulated.

In this case, blood circulation in the compressed area of ​​the organ is severely disrupted until it stops completely, and if medical assistance is not provided in time, these tissues die completely. If a girl’s ovary or fallopian tube is strangulated, sexual function is severely impaired, which can lead to.

An inguinal hernia can appear on one side, but it can also be bilateral.

Causes of inguinal hernia in children

Often, an inguinal hernia in children is congenital, and boys are more susceptible to this disease. The reason is that in some babies, during intrauterine development, the canal between the abdominal cavity and the groin region, through which the testicles should normally descend, does not close.

The situation is different for girls. The cause of an inguinal hernia in them is an abnormality of the ligaments that hold the genitals. But this disorder is more rare, so this disease is less common among girls.

The absence of an inguinal hernia at the birth of a child does not guarantee that the baby will not encounter such a problem in the future. This disorder can be acquired. its reasons may be the following:

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1 The baby has severe coughing, sneezing, vomiting, constipation, or frequent crying, which increases pressure in the abdomen. If the abdominal wall is not strong enough, the hernial orifice may open.

2 Violation of the normal position of organs can be caused by various injuries in the pubic area, which affect the integrity and tone of the anterior abdominal wall.

3 During some operations, incisions are made in the groin area that can cause an inguinal hernia. The reason for this complication may be the surgeon’s low professionalism.

4 If the canal between the abdominal cavity and the groin area does not heal in time, but the inguinal hernia did not appear before the birth of the child (congenital hernia), it may occur after birth (acquired hernia).

Inguinal hernias occur much more often in premature babies, as well as overweight babies.

Inguinal hernia in a child: symptoms

Determining the presence of an inguinal hernia in children can be quite difficult, especially if there is no clearly visible protrusion, or the child is too small to show the place that bothers him. The main symptoms of a hernia are:

1 The presence of swelling in the groin area, which increases when the child tenses. When you try to reduce it, it disappears if the hernia is reducible.

2 Anxiety, crying of a small child. Possible refusal of food or digestive disorders, vomiting. The baby becomes lethargic and there are signs of general malaise.

3 When an inguinal hernia is strangulated, the child’s well-being sharply worsens, pain and anxiety intensify. The contents of the hernial sac are not able to return to their place during manual reduction.

You should consult a doctor if you suspect an inguinal hernia in a child.

If the hernia is strangulated, the baby must be immediately sent to the hospital, where an urgent operation to remove the hernia will be performed.

Inguinal hernia in a child: treatment without surgery

Most parents faced with the problem of inguinal hernia in children strive to solve this problem without surgery. But, this treatment option is possible only in small children, up to four years old, and only in the absence of infringement.

When treating an inguinal hernia, various methods of strengthening the abdominal wall are used. For this purpose, physical exercises, outdoor games, and therapeutic massage techniques are being developed. You should not rely on traditional medicine methods. Like other medications, they have their side effects. A person without medical education cannot predict the consequences of using one or another folk remedy.

By engaging in such self-medication, parents not only delay the provision of effective assistance, but also risk harming their child.

Removal of inguinal hernia in children

Surgical removal of an inguinal hernia remains the most common and effective solution to the problem. The essence of the operation is to reduce the organs into the abdominal cavity and tighten the hernial orifice.

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The complexity and duration of the operation depends on whether the parents sought help in a timely manner. If the hernia has not yet been strangulated, the doctor examines the child, conducts all the necessary tests and performs a planned operation.

When the hernia is strangulated and every minute counts, urgent surgery is required.

Otherwise, necrotic irreversible changes begin in the compressed tissues, and peritonitis develops in the abdominal cavity. If the tissue (for example, a strangulated intestinal wall) is already dead, this area is removed, and the living parts of the organ are stitched together.

In order to reduce the negative impact of anesthesia on the child’s body, local anesthesia is usually used together with general anesthesia. To do this, the surgical site is injected with painkillers.

When performing surgery on boys, doctors must take special care not to damage the reproductive system, in particular the vas deferens. Removal of a congenital inguinal hernia is recommended to be done between the 6th and 12th months of the baby’s life. This period is most favorable for such intervention, and it is easier for the child to tolerate it.

Surgical removal of an inguinal hernia is contraindicated in children who have severe pathologies of vital organs, such as the heart and kidneys. The operation is also dangerous if the child has a progressive infectious disease in the body.

Laparoscopy of inguinal hernia in children

Recently, an alternative to conventional surgery to remove an inguinal hernia has emerged.

The laparoscopy method differs from conventional surgery in that it leaves virtually no noticeable scars, tissue damage is minimal, and recovery after surgery is much easier and faster.

If parents have the opportunity to choose this method of removing an inguinal hernia in a child, then preference should be given to it.

Complications after surgery

If the operation is performed by qualified specialists and using high-quality equipment, the likelihood of complications is minimal. But there are still cases when, during the postoperative period, a child develops a hematoma in the surgical area.