How can you recognize an inguinal hernia in a boy? —vseOspine. Symptoms of an inguinal hernia in children, treatment methods and surgery to remove it. A left inguinal hernia in a child can be treated

– pathological protrusion of the hernial sac (vaginal process of the peritoneum) together with hernial contents (loop of intestine, strand of omentum or ovary) in the groin area. An inguinal hernia in children is manifested by a painless protrusion in the groin, which increases with crying and walking and disappears at rest or in a lying position; Sometimes a child experiences a strangulated inguinal hernia. Diagnosis of an inguinal hernia in children includes consultation with a pediatric surgeon, palpation, stress tests, ultrasound of the abdominal organs, inguinal canals and scrotum. Treatment of inguinal hernia in children is exclusively surgical, predominantly laparoscopic.

General information

An inguinal hernia in children is the exit of the parietal layer of the peritoneum and internal organs through the inguinal canal under the skin. Inguinal hernias occur in approximately 5% of full-term and 15-25% of premature infants. Quite often, inguinal hernias in children are combined with a spermatic cord cyst, hydrocele, hip dysplasia, spina bifida, spinal abnormalities, connective tissue diseases (Marfan syndrome). In pediatrics and pediatric surgery, inguinal hernias in boys are diagnosed 3-10 times more often than in girls, which is most likely due to the process of migration of the testicles from the abdominal cavity through the inguinal ring and inguinal canal into the scrotum.

Causes of inguinal hernia in children

In childhood, congenital inguinal hernias occur predominantly. The main role in the formation of a congenital inguinal hernia in a child belongs to the vaginal process of the peritoneum, which is the “conductor” of the gonads from the abdominal cavity to the scrotum. Normally, after the descent of the testicles, obliteration (fusion) of the vaginal process occurs, and if this process is disrupted, conditions are created for the development of inguinal hernias in children. In fact, the processus vaginalis of the peritoneum serves as a hernial sac, which contains a loop of intestine, a strand of omentum, an ovary and a fallopian tube (in girls). In this case, the hernial orifice is the outer ring of the inguinal canal.

In the development of inguinal hernia in children, the role of hereditary predisposition is great: it is known that 11.5% of children with this pathology have one of the parents who previously underwent hernia repair.

Acquired inguinal hernias in children are extremely rare. They usually occur in school-age boys who experience increased physical activity and have severe weakness of the muscles of the anterior abdominal wall.

Classification of inguinal hernias in children

Congenital inguinal hernias in children, as a rule, are oblique, that is, they descend into the inguinal canal through the internal inguinal ring. Direct inguinal hernias in children occur in extremely rare cases; they exit through a muscle defect in the abdominal wall in the projection of the external inguinal ring.

Depending on the location, inguinal hernias in children can be right-sided, left-sided or bilateral. At the same time, in boys, in 60% of cases, right-sided inguinal hernias occur, in 30% - left-sided, and in 10% - bilateral. In girls, more than half of the cases are inguinal hernias on both sides.

In addition, inguinal and inguinal-scrotal hernias occur in boys. In turn, inguinal-scrotal hernia in children can be cordal (funicular, 90%) and testicular (testicular, 10%). With a cord hernia, the peritoneal process is partially obliterated only in the lower part and is open in the upper and middle parts. In the case of a testicular hernia, the vaginal process of the peritoneum is not closed along its entire length, which is why the testicle, surrounded by serous membranes, protrudes into the lumen of the hernial sac.

Symptoms of inguinal hernia in children

A congenital inguinal hernia in children can be noticed already in the newborn period. Its main manifestation is a hernial protrusion in the groin area, which increases with straining, coughing, or crying of the child and decreases or completely disappears at rest. The swelling in the groin area is painless and has an oval or round shape. There may be a nagging pain in the lower abdomen and thigh.

With an inguinal-scrotal hernia in boys, the hernial sac descends into the scrotum, leading to stretching and asymmetry of one half of it. In girls, the hernial protrusion may extend into the labia majora.

A dangerous complication of an inguinal hernia in children is its strangulation - compression (strangulation) of an intestinal loop, omentum or ovary trapped in the hernial sac by the external inguinal ring, which is accompanied by circulatory disorders in the strangulated organs. Flatulence, constipation, and increased intra-abdominal pressure can contribute to strangulated inguinal hernia in children.

When an inguinal hernia is strangulated, children become restless, cry, and complain of pain in the groin. The hernial protrusion becomes sharply painful, tense, and cannot be retracted into the abdominal cavity. As a result of developing intestinal obstruction, vomiting, persistent gases, and bloating may soon appear. Necrosis of the intestinal wall can result in perforation and peritonitis.

Ovarian tissue is most sensitive to impaired blood supply in girls, so even short-term strangulation can cause death of eggs or necrosis of the organ. Poor blood supply to the testicle occurs in 5% of boys with strangulated inguinal hernias and can contribute to testicular atrophy. Thus, strangulated inguinal hernia in children is a risk factor for decreased reproductive abilities in adulthood.

Diagnosis of inguinal hernia in children

An inguinal hernia in children can be detected in a child by a pediatric surgeon or pediatrician during a routine examination, or by the parents themselves. Diagnosis of inguinal hernia is based on history, examination, palpation and ultrasound in children.

To detect an inguinal hernia, the child is asked to bend over, strain, cough, and walk. Palpation of the protrusion reveals its soft or elastic consistency. In a horizontal position, an uncomplicated inguinal hernia in children is easily reduced into the abdominal cavity; if the intestine gets into the hernial sac, a characteristic rumbling sound is heard when the hernia is reduced. After reduction of the hernia, it is possible to clearly palpate the enlarged inguinal ring. To clarify the diagnosis, ultrasound of the abdominal organs, ultrasound of the inguinal canals, ultrasound of the pelvis in girls are performed, and, if necessary, irrigography.

It is necessary to differentiate an inguinal hernia in children from hydrocele, spermatic cord cyst, cryptorchidism (in boys), round ligament cyst of the uterus (in girls), inguinal lymphadenitis, femoral hernia. A certain value in differential diagnosis belongs to diaphanoscopy of the scrotum and ultrasound of the scrotum.

Treatment of inguinal hernia in children

The only radical treatment option for inguinal hernia in children is surgery. Conservative methods (bandages, dressings) are currently not used in pediatric surgery.

Uncomplicated inguinal hernia in children is operated on routinely, usually at the age of 6-12 months. The essence of the hernia repair operation (hernioplasty) is to isolate, ligate and cut off the hernial sac, restoring the normal anatomy of the inguinal canal. If necessary, the inguinal canal is strengthened using your own tissue or polypropylene mesh. Herniotomy surgery for children can be performed openly or through laparoscopy. During the operation, trauma to the elements of the spermatic cord (vessels of the testicle and vas deferens) should be avoided, since damage to them can cause death of the testicle or disruption of reproductive function.

A strangulated inguinal hernia in girls in all cases is an indication for emergency surgery (due to the high risk of death of the strangulated ovary and fallopian tube).

In a boy, in the first hours after a strangulated inguinal hernia, an attempt at conservative treatment may be made to independently reduce the hernial contents: a warm bath, the administration of antispasmodics, and placing the child with an elevated pelvis. In the absence of the desired effect, emergency surgical intervention is indicated. A peculiarity of surgery for strangulated inguinal hernias in children is the need to assess the viability of the contents of the hernial sac before its reduction. If the viability of the omentum, intestine and other elements of the hernial sac is in doubt, they are resected.

Prognosis and prevention of inguinal hernia in children

The results of surgical treatment of uncomplicated inguinal hernias in children are in most cases good. Currently, surgery for an inguinal hernia is performed in a day hospital, so the child can be released to go home on the same day. The outcomes of surgical treatment of strangulated inguinal hernias in children depend on the timing of the intervention; the mortality rate is about 0.5%.

Recurrences of inguinal hernia are observed in less than 1% of cases, usually in premature infants, with connective tissue diseases, and during emergency interventions. Among the complications associated with violation of the hernia repair technique are lymphostasis in the testicle, lymphocele, high testicular fixation, and infertility.

Since congenital inguinal hernias are mainly observed in children, the main preventive measure for their occurrence is the timely identification of risk factors for the disease and regular examination of the child by pediatric specialists, primarily a pediatric surgeon. Prevention of acquired inguinal hernia in children is achieved by rational nutrition, regulation of intestinal function, treatment of constipation, and exclusion of heavy physical activity.

An inguinal hernia in children is a protrusion through the inguinal canal of the vaginal process of the peritoneum, forming a hernial sac, which includes some internal organs (hernial contents). In children, inguinal hernias are usually congenital. Acquired ones are observed extremely rarely - they develop in school-age boys who have a weak abdominal wall or engage in weightlifting.

Inguinal hernias in children are most often congenital

Inguinal hernias in children are a widespread pathology. They are observed in 5% of full-term and 20-25% of premature babies. Often combined with other pathologies:

• spermatic cord cyst;
• Marfan syndrome and other connective tissue diseases;
• developmental anomalies of the spinal column;
• spina bifida;

Inguinal hernias in children are three times more common in boys. Presumably, this is due to the process of migration of the testicle into the scrotum from the abdominal cavity through the inguinal canal.

Causes and risk factors

The main role in the formation of congenital inguinal hernias in children belongs to the blind pouch of the peritoneum (vaginal process) protruding through the inguinal canal into the scrotum. After the testicle descends into the scrotum, the processus vaginalis becomes obliterated, i.e., overgrown. This usually happens around the time the baby is born. If for some reason obliteration does not occur, then the inguinal canal does not close and when intra-abdominal pressure increases, internal organs emerge through it. The hernial orifice is the outer ring of the inguinal canal, and the processus vaginalis of the peritoneum is a hernial sac, which may include intestinal loops, omentum, fallopian tube and ovary (in girls).

In the development of inguinal hernia in children, hereditary predisposition plays an important role. According to statistics, approximately 12% of children with this pathology also had an inguinal hernia in one or both parents.

Acquired inguinal hernias in children, as mentioned above, are extremely rare. Factors provoking their development:

• sudden weight loss;
• lifting weights;
• respiratory diseases accompanied by severe cough;
• chronic constipation.

Forms of the disease

Depending on the location, inguinal hernias in children are bilateral, left-sided and right-sided. In girls, bilateral hernial protrusions are observed in 50% of cases. In boys, bilateral inguinal hernias occur in 10% of cases, in 30% - left-sided, and in the remaining cases - right-sided.

As a rule, in children, inguinal hernias pass through the internal inguinal ring and are located in the inguinal canal, i.e. they are oblique. Direct inguinal hernias are extremely rare in pediatric practice. In this case, the hernial protrusion passes through a defect in the muscles of the anterior abdominal wall in the area of ​​the external inguinal ring.

Inguinal hernias in children are a widespread pathology. They are observed in 5% of full-term and 20-25% of premature babies.

In boys, the hernial sac can descend into the scrotum, which leads to the formation of inguinal-scrotal hernias, which, in turn, are divided into testicular (ovarian) and funicular (cordial).

Symptoms of inguinal hernia in children

The main symptom of an inguinal hernia in children is the presence of a tumor-like protrusion in the groin area. When the child strains, cries, screams, or coughs, it increases in size, at rest it decreases, and sometimes disappears completely.

With an inguinal-scrotal hernia in boys, deformation of the scrotum is observed due to the lowering of the hernial sac into it. In girls, the hernial sac may descend into one of the labia, causing it to thicken.

Inguinal hernias in children are often accompanied by pain localized in the lower abdomen or groin area. The pain may radiate to the lower back or sacrum. They can cause crying and whims in children in the first year of life. At an older age, children tell their parents about pain in the lower abdomen.

Diagnostics

An inguinal hernia in children is usually discovered either by the parents themselves or by a doctor during a routine examination.

Palpation reveals an elastic or soft consistency of the protrusion in the groin area. In an uncomplicated course, the hernial contents are easily reduced into the abdominal cavity. At the moment of reduction, you can hear a characteristic rumbling sound, which indicates the presence of an intestinal loop in the hernial sac. After the hernial protrusion is reduced into the abdominal cavity, the expanded external inguinal ring is palpated.

Inguinal hernias in children are three times more common in boys. Presumably, this is due to the process of migration of the testicle into the scrotum from the abdominal cavity through the inguinal canal.

To clarify the diagnosis, perform:

• ultrasound examination of the abdominal organs, pelvis, inguinal canals and scrotum;
• irrigography;
• cystography.

Inguinal hernia in children requires differential diagnosis with the following diseases:

• cyst of the round ligament of the uterus (in girls);
• cryptorchidism (in boys);
• spermatic cord cyst (in boys);
• hydrocele (in boys).

Treatment of inguinal hernia in children

Currently, conservative treatment of inguinal hernias in children using adhesive bandages and bandages is not carried out.

Removal of an inguinal hernia in children with an uncomplicated course is performed routinely after the age of six months. During surgery, the surgeon isolates, ties and cuts off the hernial sac, and then performs plastic surgery of the hernial orifice using the patient’s own tissue or using a special propylene mesh.

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Surgery for inguinal hernia in children can be performed using the classic open method or using laparoscopic technologies. The latter method is more preferable, as it is accompanied by minimal trauma to soft tissues, minor blood loss and a short rehabilitation period.

Removal of an inguinal hernia in boys should be performed with great care to avoid possible injury to the vas deferens and vessels of the testicle (spermatic cord). Their damage subsequently leads to testicular atrophy and/or male infertility.

The development of a strangulated inguinal hernia in girls is an indication for emergency surgery, since there is a very high risk of death of the fallopian tube or ovary. In boys in the first months of life, when strangulation develops in the first few hours, conservative therapy is carried out, aimed at self-reduction of the hernia. In this case, the following treatment regimen for inguinal hernia in children is used:

• warm bath or heating pad;
• intramuscular administration of drugs that have an antispasmodic effect;
• giving the child a position with an elevated pelvis.

If treatment does not lead to strangulation of the inguinal hernia, emergency surgery is resorted to. For strangulated inguinal hernias in children, the operation has its own characteristics. First of all, the surgeon must assess the viability of the organs included in the hernial sac. Reduction into the abdominal cavity is possible only if the viability of the intestine, omentum, ovary or other elements is beyond any doubt. Otherwise, they are resected.

Recurrence of inguinal hernias in children is observed in 1% of cases (most often after emergency interventions or in premature infants).

Possible consequences and complications

The main complication of an inguinal hernia in children is its strangulation. It develops as a result of compression of the hernial contents (ovary, omentum, intestinal loop, bladder wall) by the external inguinal ring, which leads to ischemia of the strangulated organs.

Constipation, flatulence, and severe cough can provoke the development of infringement.

The main symptoms of inguinal hernia strangulation in children are:

• pain in the groin (small children cry, press their legs to their stomach);
• the hernial protrusion becomes tense and sharply painful on palpation, it is impossible to reduce it into the abdominal cavity;
• nausea, repeated vomiting;
• delayed passage of gas and stool.

If surgical treatment is delayed, the child develops peritonitis.

Ovarian tissue is very sensitive to ischemia, so even short-term strangulation can cause ovarian necrosis and egg death.

Infringement is also dangerous for the male reproductive system. Thus, 5% of boys, after suffering an inguinal hernia strangulation, subsequently develop testicular atrophy.

Forecast

Removal of uncomplicated inguinal hernias in children is currently performed in most cases in a day hospital. The child is discharged for outpatient treatment on the day of surgery or the next morning.

Recurrence of inguinal hernias in children is observed in 1% of cases (most often after emergency interventions or in premature infants).

Complications of hernia repair occur extremely rarely. These include:

• infertility;
• high testicular fixation;
• lymphocele;
• testicular lymphostasis.

Prevention

Prevention of the formation of inguinal hernias in children includes:

• body weight control;
• treatment of constipation;
• treatment of respiratory diseases accompanied by cough;
• physical activity appropriate for age and muscle strength.

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Any diseases that occur in childhood require timely diagnosis and immediate treatment. Surgery to remove an inguinal hernia in children is performed as quickly as possible.

A hernia refers to the release of abdominal organs into the inguinal canal. Only with the help of surgical treatment can one get rid of the disease.

Features of the occurrence of hernias in children

In children, a predominantly congenital type of pathology occurs. In boys, the disease occurs due to pathological protrusion of the peritoneum in the area of ​​the vaginal process. This name refers to the opening through which the testicles descend into the scrotum during the process of intrauterine formation.

As the baby develops, the pocket becomes overgrown, but if the descent of the testicle into the scrotum is disrupted, the canal remains open and a pathological protrusion of the internal organs occurs in the groin area.

Girls have a shorter inguinal canal than boys, so the latter more often suffer from pathology (more than 60%). In girls, the disease is predominantly associated with weakness of the connective tissue and abnormalities of the pelvic girdle.

Children born prematurely are at risk. In premature babies (before 36 weeks), pathology occurs 5 times more often.

What parents should know about the disease

An inguinal hernia is a serious pathology that requires careful attention, and under no circumstances should you delay its treatment. When faced with a disease, parents should know the following:

1. It is better to carry out the operation as planned, without waiting for complications.
2. The pathology is dangerous due to the risk of strangulation.
3. If an injury occurs, it is necessary to immediately take the child to the hospital, no matter what time the clock shows.
4. Emergency intervention significantly increases the risk of severe consequences and relapses.

Today, medicine has the necessary knowledge and equipment to completely cure the pathology without risking the baby’s health.

Indications and contraindications for surgery

The appearance of a hernia is the main indication for surgery. It is not carried out in the following cases:

• blood diseases;
• pathology of the cardiovascular system;
• acute infection;
• severe renal and liver failure;
• high body temperature;
• neurological disorders.

If there are contraindications, conservative treatment is carried out, which consists of strengthening the baby’s muscles with massage, gymnastics, and wearing a bandage.

If complications develop, surgical intervention is performed on an emergency basis. Indications are signs of strangulated hernia:

• development of tissue necrosis;
• inflammatory process;
• intestinal obstruction;
• severe pain syndrome.

Preparing a child for surgery

As a rule, an inguinal hernia operation in a child is performed using modern methods that are characterized by safety and minimal trauma to the patient’s tissue. The procedure for excision of hernias using the laparoscopic method takes no more than an hour, is well tolerated by young patients, is rarely accompanied by relapses, and does not leave scars.

To exclude complications, the baby undergoes a comprehensive medical examination, including laboratory tests of blood and urine. The doctor assesses the patient’s well-being and studies the medical history. Before surgery, consultation with a pediatrician, cardiologist, or neurologist is required.

The choice of anesthesia depends on the individual characteristics of the patient. Today, modern drugs are used that reduce the risk of complications. Anesthesia is carried out using combination drugs, approved even for newborns.

Doctors' opinions on the timing of surgical treatment are divided. Some believe that excision of a hernia is best done in the second half of life, others argue that it is necessary to wait until the child is 4 years old.

Today, operations are increasingly being performed in infancy. The elasticity of the child’s tissues and the ability to quickly regenerate ensure the success of the treatment.

Open method of surgery

Inguinal hernia surgery in children is performed using closed and open methods. Open surgery involves:

1. An incision in the area of ​​the hernia. The incision is small, up to 7 cm. The skin is dissected in layers, this eliminates serious tissue damage.
2. Detection of the hernial sac.
3. Assessment of the condition and repositioning of internal organs into the peritoneal cavity. If there is tissue damage, the surgeon decides to remove part of the intestine or omentum.
4. Stitching the inguinal opening - at this stage one of the techniques is used. These are tension (tightening and suturing the patient’s own tissues) and non-tension plastic (the inguinal opening is closed with a mesh implant).
5. Applying sutures to the dissected abdominal tissue.

Open surgery should be done for complicated hernias and large protrusions. For planned intervention, the laparoscopy method is used.

Features of laparoscopy

Laparoscopy is the performance of the necessary medical procedures to remove a hernia using small punctures in the abdominal wall. Through punctures, a microscopic endoscope (video camera) is inserted into the navel area, and tubes for micro-instruments are inserted into the other two holes. After reducing the protrusion, it is necessary to remove the tissue of the hernial sac, and then perform plastic surgery to close the hernial orifice using your own muscles or a special mesh, which must be left and sewn to the aponeurosis of the rectus abdominis muscle. Skin punctures are stitched with internal cosmetic sutures. This eliminates the formation of scars on the body. The procedure lasts no more than half an hour. The disadvantage of this method is that it cannot be used for large hernias. Among the advantages are:

• absence of postoperative scars;
• short-term recovery period;
• elimination of severe pain;
• rare relapses.

The use of laparoscopy accounts for no more than 15% of all operations. This is due to the high cost of treatment, lack of equipment and qualified specialists with the necessary knowledge about the procedure. After endoscopic surgery, the child can get up within 1-2 hours.

Complications after surgery

After elective surgery, complications occur extremely rarely. On the first day, small hematomas and hemorrhages may be observed at the incision site. Most often, such manifestations disappear on their own after a few days. Very rarely it is necessary to operate again to pump out the hematoma.

The most common complications that occur are:

• development of severe pain syndrome;
• swelling of the scrotum;
• suppuration of the postoperative scar;
• wound infection.

If the hernia was of significant size, a recurrence of the pathology is possible. Most often, complications of this type occur in children born prematurely and in children with significant developmental defects.

Many years after the operation, it can leave a mark that manifests itself in the form of infertility. This occurs due to damage to the spermatic cord. In girls, a negative consequence may be displacement (rotation) of the uterus due to cutting of the round ligament of the uterus.

To prevent severe complications, treatment should be performed in a timely manner and thorough preparation should be carried out before future surgery.

Features of rehabilitation

After the operation, children recover quickly. The task of parents is to be attentive to the baby. After discharge from the hospital, it is necessary to monitor the cleanliness of the child’s bandages and eliminate reasons for physical activity. It is important to visit your doctor as scheduled.

Diet plays an important role. If the child is not breastfed, the diet should consist of soups, jelly, vegetables, and fruits. Nutrition is adjusted to avoid constipation and vomiting. Flour products, sweet pastries, chocolate, fatty dairy products, fish and fatty meats are excluded. Preference should be given to food prepared by steaming and boiling.

To prevent infection from getting into the wound, swimming is prohibited for the first 5-7 days. Water procedures are carried out after the stitches have healed. If suppuration, redness or swelling develops in the scar area, you cannot self-medicate, you must immediately consult a doctor.

After removing the bandage, the wound is treated for some time with a 5% iodine solution, brilliant green or peroxide. It is necessary to ensure that no dirt or dust gets into the wound.

If you follow all the prescribed rules, recovery will take place quickly, without consequences. Exercising and maintaining a normal body weight for the child will prevent recurrence of the disease in the future.

Inguinal hernia in boys is a phenomenon quite common in children.

This pathology in children is most often congenital However, in some cases, for example, with excessive physical activity, excess body weight, the defect is acquired.

general information

Inguinal hernia in a baby - photo:

The disease is a specific protrusion that can be observed in the scrotum and groin area. Most often, this protrusion appears on the right side. An inguinal hernia may be bilateral.

The disease develops when the abdominal organs are not in their place, but fall out into the groin area. A hernial sac is formed, the contents of which become an intestinal loop, the omentum.

The defect is most often congenital when the boy has the process of testicular descent is disrupted from the abdominal cavity to the scrotum.

Thus, the prerequisites for the development of pathology are detected in the prenatal period, and after the birth of the baby, the manifestations of the disease progress.

In some cases, an inguinal hernia proceeds steadily, without causing any discomfort to the child, but, in most cases, the presence of a hernia hurts the boy, negatively affects his overall well-being.

Reasons for appearance

In newborns, the cause of the disease is congenital.

It is known that in the prenatal period The boy's testicles are located in the abdominal cavity; they descend into the scrotum after the baby is born.

If this process is disrupted for some reason, not only the groin area, but also fragments of other abdominal organs can get into the groin area.

This happens as a result of intrauterine development anomalies, for example, when there is threat of miscarriage, fetal hypoxia, other unfavorable factors complicating the course of pregnancy.

In older children, an inguinal hernia may occur as a result of excessive physical activity, for example, when playing strenuous sports, when lifting weights.

The risk of developing pathology increases if the child is overweight.

How to recognize?

Inguinal hernia in boys is a disease that has a range of characteristic symptoms. Among them are:

1. Education in the groin area specific compactions, protrusions.
2. The compaction has various sizes, from insignificant to very large, when several loops of intestine fall into the groin area.
3. Education has round or oval form.
4. The seal is easily detected by palpation; it feels soft.
5. If there are no complications (pinching), small protrusions can be easily reduced with slight pressure.
6. When you press on the seal, you hear a characteristic gurgling sound.
7. When the baby tenses the abdominal muscles, for example, with strong crying, coughing, tightness increases in size.

In some cases, when a child has a pinched hernia, symptoms of intoxication of the body and disruption of the functioning of the gastrointestinal tract appear.

In particular, these are nausea and vomiting, bloating as a result of impaired gas discharge, disruption of the defecation process, sudden temperature increase body to high values, pain in the groin area.

All this negatively affects the child’s health and well-being. This phenomenon requires urgent hospitalization and emergency surgery.

Why is a hernia of the linea alba dangerous in a baby? find out right now.

Features of the inguinoscrotal

An inguinal-scrotal hernia develops if there is weakness of the connective tissue of the inguinal ring, which in this case is a natural opening through which the abdominal organs prolapse into the scrotum.

The inguinal ring tends to contract and expand, as a result of which the risk of a hernia being pinched significantly increases.

Inguinoscrotal hernia, in the absence of complications, often has hidden symptoms, the presence of a protrusion can only be noted if the child tenses his abdominal muscles. In a calm state, clinical manifestations may be absent.

Why is it dangerous?

The most common complication of the disease is considered pinching inguinal hernia.

This phenomenon is considered very dangerous for the child’s health, as it provokes disruption of the digestive system and contributes to the development of symptoms of intoxication of the body.

In addition, the strangulated organ dies over time ( necrosis), this leads to irreversible consequences.

In some cases, when the appendix prolapses into the hernial sac, the child develops symptoms characteristic of this disease. The inflammatory process begins, poisoning the body. The child needs urgent medical care.

The lack of proper treatment of an inguinal hernia in childhood can subsequently lead to serious problems in the functioning of the genitourinary system.

In particular, the processes of urination are disrupted; infertility.

Diagnostics

In order to determine the presence of a disease, it is necessary to show the child to the surgeon. To make a diagnosis, the doctor examines the patient and identifies the clinical picture of the disease.

Externally, the symptoms of an inguinal hernia resemble those of dropsy, so when making a diagnosis, it is important to pay attention to the symptoms that are characteristic only of a hernia.

An experienced specialist can quite easily make the correct diagnosis.

However, in some cases, to confirm it laboratory methods are also required diagnostics:

• general analysis of urine, feces;
• biochemical blood test;
• Ultrasound to determine the contents of the hernial sac and assess the condition of the abdominal organs.

Conservative treatment methods

Children under five years of age are usually prescribed conservative treatment for an inguinal hernia (the exception is the presence of incarceration). Others contraindications for surgery are considered:

• diseases of the kidneys, organs of the cardiovascular system;
• peritonitis, sepsis, acute infectious diseases;
• blood clotting disorder;
• intestinal dysfunction (intestinal obstruction);
• obesity;
• recent other surgical interventions.

Non-surgical treatment methods give positive results if the size of the hernia is small and it is well reduced.

In this case, the child is prescribed to use special bandage, which helps keep the abdominal organs in their place and prevents them from protruding into the groin area.

In addition, it is necessary to systematically strengthen the muscle tissue of the walls of the abdominal cavity and inguinal ring.

Designed for this special set of physical exercises:

Exercises must be repeated 2 times a day, daily. At the same time, it is important to ensure that the child does not overexert himself, does the exercises easily, and does not experience excessive stress.

In what cases is surgery necessary?

Surgical treatment is considered the most effective method to eliminate the defect. However, surgery is usually not prescribed for young children.

Emergency surgery is necessary if the disease progresses rapidly and causes severe pain to the child. The presence of strangulation is also an indication for urgent surgical intervention.

The operation is considered quite simple and safe for a child. Its duration usually does not exceed half an hour. On the 4th-5th day the baby is discharged from the hospital. Sutures are removed 7-10 days after surgery.

Rehabilitation

During the postoperative period (for 2 months), the child must wear special elastic swimming trunks. This helps maintain the scrotum in a physiological position, promotes faster healing of wounds, and reduces the risk of relapses.

It is necessary to pay attention to the child’s lifestyle. Strong physical activity and excessively active games are not recommended for the baby.

The diet should include high-calorie foods, rich in protein.

To prevent wound infection, the baby is prescribed a prophylactic dose. antibiotics wide spectrum of action.

You will find information on the treatment of hematoma on the head of a newborn after childbirth on our website.

Prevention

It is possible to reduce the risk of developing an inguinal hernia in a child if you follow simple rules, such as:

• timely treatment of severe cough, prevention of constipation, which may cause a hernia;
• proper nutrition, taking vitamin supplements, strengthening the child’s immune system;
• limiting excessive physical activity.

An inguinal hernia is a phenomenon that can not only cause discomfort to the baby, but also threaten his health if it occurs complications.

The disease can be congenital (develops in the prenatal period), or acquired when there are unfavorable factors that contribute to its appearance.

The pathology has a number of specific symptoms; in the presence of complications, the clinical picture becomes more extensive.

The main method of treatment is surgery However, in some cases conservative therapy is used.

Dr. Komarovsky about hernias in children in this video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

In children, an inguinal hernia is an unnatural protrusion of the vaginal process of the peritoneum (hernial sac) with its contents. It looks like a round seal protruding above the general surface of the skin. It increases in a child when walking, and decreases at rest. The disease is diagnosed by pediatric surgeons using palpation, stress tests, and ultrasound examination of the abdominal cavity, scrotum, and inguinal canals. So, let's learn about childhood inguinal hernia in more detail.

Inguinal hernia in children: causes

A number of factors contribute to the formation of a hernia in a child’s groin:

1. Abdominal wall injury.
2. Physical overexertion.
3. Excess body weight.
4. Underdevelopment of the abdominal wall, which is inherited.

Statistics show that inguinal hernia occurs more often in boys than in girls, and this is due to the patterns of intrauterine development. At a certain stage of intrauterine development in boys, the testicles are located near the kidneys. And when they descend into the place allocated to them by nature, that is, into the scrotum, the testicles take with them a piece of the peritoneum. This is how a “pocket” of connective tissue is formed in the scrotum. When a child is born, the “pocket” becomes overgrown, turning into a heavy tissue. But it doesn’t always overgrow. In this case, the unfilled “pocket” becomes the site of prolapse of the peritoneal organs.

Since girls do not have a peritoneal processus vaginalis, an inguinal hernia rarely bothers them.

This disease can be congenital or acquired. It is more common in adults. Both congenital and acquired forms of the disease require special treatment. In most cases, surgery is necessary to completely get rid of it.

Symptoms of inguinal hernia in children

A congenital inguinal hernia is formed at the stage of intrauterine development. Pathology most often has a one-sided concentration. And mainly this is the right side of the groin.

But the option of a left-sided inguinal hernia cannot be ruled out. Its symptoms occur in 25% of cases. Medical statistics show that pathology occurs in young patients in the first year of life, more often in the first three months.

As for the symptoms of this disease, in addition to the main one - specific protrusion - it is also painful. In boys, the protrusion in the groin has a round shape, and in the case of an inguinal-scrotal hernia, its shape is oval. In the second option, the protrusion of the peritoneal process towards the scrotum descends. This, in turn, causes tissue stretching. There is an increase in signs of infringement.

A hernia in a child’s groin is manifested by restless behavior and constant crying. The protrusion becomes hard. But when the child is lying down, it can significantly decrease in size (visually).

Sometimes, when pressed, reduction is possible, which is accompanied by a specific rumbling sound.

When the child coughs or sneezes, the protrusion becomes larger. And if you put your hand on it at this time, you can feel its tension. Most often, inguinal hernias are not accompanied by other symptoms. Only in rare cases may a child be bothered by bloating or indigestion.

According to statistics, this disease occurs much less frequently in girls than in boys. And the reason for this is that before a girl is born, her uterus is located much higher than after birth. During intrauterine development in girls, the uterus gradually descends. This, in turn, displaces the peritoneum along with it. As a result, a fold is formed by the peritoneum, which forms a kind of pocket if it protrudes forward and penetrates the groin area. This is how an inguinal hernia forms in girls.

But in female representatives, pathology also occurs for other reasons. This is excessive physical activity, severe abdominal strain.

Inguinal hernia strangulation in children

The situation is very serious if the hernial protrusion is pinched. This condition requires prompt medical attention.

In medicine, it is customary to classify inguinal hernia strangulation:

1. Fecal impaction.
2. Elastic.
3. Retrograde infringement.
4. Richter's pinch.

All four types in a child are accompanied by severe pain and tissue cyanosis. The hernial contents become very tense, they become hard and cannot be reduced. The child does not just experience severe discomfort. It screams, which unconsciously further aggravates the painful state of infringement.

Why is an inguinal hernia dangerous in children?

The danger lies precisely in the possibility of infringement. And pediatric statistics state that this condition is observed in 20% of all cases in children. Incarceration means that the intestine is stuck in the inguinal canal and the blood vessels in the groin have become bent and blocked. The result of this circulatory pathology is manifested by severe pain, sometimes vomiting and nausea of ​​the baby, his anxiety and nervousness, crying and screaming. Pediatricians and surgeons in such cases recommend emergency surgery.

You should know that congenital hernias in children can be cured mainly through surgery. Such operations are planned, because conservative treatment brings an inconsistent effect. This means that the child is always at risk of strangulated hernia. As a rule, operations are prescribed at the age of 6 months. They are performed under general short-term anesthesia.

The entire operation lasts 15 minutes. Since the child’s inguinal ring is not fully formed, surgeons usually cut off the hernial sac. To facilitate the operation, the inguinal ring is not strengthened.

Treatment of inguinal hernia in children without surgery

All parents are interested in whether it is possible to do without surgical intervention when making such a diagnosis for a child. After all, at this age, every mother is afraid to operate on a child, no matter how simple the operation.

You should know that conservative treatment for an inguinal hernia is wearing a bandage. It can be one-sided or two-sided. Its purpose is to prevent prolapse of the hernial sac and keep it in the abdominal cavity. The bandage is put on the baby in a supine position. At first it causes discomfort, but over time the child gets used to it. It is recommended to wear the bandage only during periods of wakefulness of the small patient. But if he is not completely healthy and is bothered by a cough, then the bandage is left on overnight. Once a day it should be removed to wipe the baby’s skin and allow it to breathe.

If the bandage is worn for a long time, the muscles become “lazy” and atrophy occurs. This is why wearing a bandage is not an alternative to surgery to remove a hernia.

If we are talking about an inguinal hernia in premature and weakened children, then they try to correct it using conservative methods. This includes giving the baby solutions of promedol and atropine, a warm heating pad on the stomach, putting the baby to bed with his legs elevated, and prescribing warm baths. If there is no positive effect from this, then surgery is prescribed.

Treatment of inguinal hernia in children with folk remedies

We immediately emphasize that you can try to treat a child at home only if there is no infringement. The famous healer Vanga recommended doing this using compresses with wormwood infusion. Other herbalists recommend trying applying a leaf of sauerkraut or a compress of sauerkraut brine to the protrusion several times a day.

You can try rinsing the hernia area daily with a very weak solution of acetic acid. After this, you need to apply a compress from a decoction of oak leaves.

The treatment effect is sometimes achieved with hernia compresses. This herb has long been used in Rus' to treat all types of hernia formations. The herb is scalded with boiling water and applied warm to the problem area. Do this several times a day.

In addition to applying compresses, traditional healers also recommend drinking infusions of cornflower and gooseberry leaves, larch bark and meadowsweet herb. But this applies more to treatment in adults.

Inguinal hernia in children: Komarovsky

A well-known pediatrician believes that parents should not hope for the resorption of the hernia formation. The likelihood of this happening is very low. He considers surgery for an inguinal hernia in a child inevitable. But the urgency of surgical intervention is determined by the size of the protrusion and the child’s state of health. Evgeniy Komarovsky is confident that conservative treatment methods will only temporarily alleviate the baby’s condition before surgery.

Especially for - Diana Rudenko