Symptoms of a hernia on the abdomen in a child. Hernia of the white line of the abdomen: causes of the disorder in newborns and older children, symptoms, treatment. Causes of the disease

Hernia developed due to diastasis of the abdominal muscles

Any mother should be wary if her child often has a stomach ache. If the pain intensifies, you should immediately consult a surgeon. He will first examine the little patient and then refer him for additional examination.

In addition to palpation, a hernia of the white line of the abdomen is diagnosed using ultrasound and computed tomography of the abdominal organs. In addition, the doctor may prescribe x-rays of the stomach and duodenum, gastroscopy or herniorrhaphy. The last examination method involves injecting a contrast agent into the peritoneum to examine the hernia.

Once the diagnosis is confirmed, the child should be immediately scheduled for surgery. There is no other way to cure a hernia of the linea alba. When preparing for surgery, you need to exclude certain foods from your diet.

First of all, these are spicy and fatty dishes, including spices. The mother should ensure that the child who has been diagnosed with a hernia of the linea alba does not have butter, processed foods, various snacks (for example, chips, crackers), tomatoes, lemons, or chocolate on the menu. In addition, it is recommended to exclude vegetables and legumes from the diet, which cause bloating, colic and constipation. And in order to further reduce the load on the peritoneum, the child needs to be fed often, but in small portions.

When preparing a child for surgery, you need to feed him dishes made from brown rice, cereals, and vegetables - in particular carrots, cucumbers, and asparagus. You can also give fruits, fish, low-fat cheese, egg whites, cauliflower and lean veal. But we must remember that such a diet is not a treatment, but only relieves the stomach and intestines before surgery.

Surgical intervention for a hernia of the linea alba in a child is called hernioplasty and is performed under general anesthesia. Depending on the degree of the disease, hernioplasty is performed using local (native) or artificial material (synthetic prostheses).

During the operation, the doctor is faced with the task of not only opening the hernial sac and removing its contents, most often this is a small part of the omentum, but also eliminating the discrepancy of the rectus abdominis muscles - diastasis. Only preventing further diastasis guarantees a complete cure for a hernia of the white line of the abdomen.

When hernioplasty using local (own) tissues, the defect of the aponeurosis (wide tendon tissue) is eliminated using a synthetic non-absorbable thread. This type of surgical intervention often leads to recurrence of the hernia, since the load on the sutures is quite large and they can erupt.

Therefore, most often the operation is performed using a synthetic mesh frame, which covers the aponeurosis and evenly distributes the load on the sutures. Since connective tissue grows through the allomaterial without difficulty, the likelihood of relapse is negligible.

The entire operation takes no more than an hour, and the next day, if there are no complications, the child can be discharged home. Although the doctor may leave him in the hospital for another two days. The stitches will be removed only after a week or a week and a half.

After surgery, a rehabilitation period begins, which is accompanied by a special diet and abstinence from physical activity.

Both before and after surgery, you should not give your child spicy, fatty or fried foods. To make the digestion process easier for the stomach, you need to focus on liquid foods: porridge, purees, fermented milk products.

In order for the intestines to empty regularly, the child after surgery should eat liquid oatmeal, drink light vegetable and chicken broth, low-fat yogurt, kefir or yogurt. You can also give your child milk and fruit jelly.

To improve peristalsis, it is necessary to add fruit and vegetable purees and juices to the little patient’s diet. But you should not overuse fiber, as its excess can lead to flatulence and colic.

In addition, for a faster recovery, children after surgery should be given vitamins C and B, as well as calcium.

A hernia of the linea alba in a child appears when the midline is weakened. The elastic tendon plate may have congenital gaps due to underdeveloped structure. The two main factors that influence the development of the disease are weakness of the muscles of the anterior abdominal wall and increased intra-abdominal pressure.

In medicine, hernias of the white line of the abdomen are divided into three types:

In 80% of cases, pathology occurs in the upper abdomen. In this area the tendon is widest and softest. The anatomical structure of the body in children practically prevents the formation of an umbilical hernia. Below the navel, the tendon becomes narrow and strong, which also reduces the risk of developing a formation.

With an increase in intra-abdominal pressure, a small tubercle appears at the site of the divergence of the aponeurosis. Adipose tissue penetrates the gap and a lipoma forms. Quite often it is mistakenly associated with other diseases.

Gradually, the hernial opening enlarges, and part of the outer part of the abdominal cavity falls into it. This is how a hernial sac appears, into which the internal organs fall.

The main reasons for the development of the disease:

1. heredity;
2. congenital pathologies and weakness of the white line or abdominal wall;
3. peritoneal injuries;
4. previous operations on the abdominal organs;
5. weight loss;
6. exhaustion or significant weakening of the body due to past illnesses.

The reasons for the increase in intra-abdominal pressure, which provokes the occurrence of formation in children and newborns:

1. prolonged crying (the child seems to be tearing himself apart);
2. chronic constipation;
3. excessive physical activity;
4. excess weight;
5. chronic cough;
6. postoperative scars and scars on the abdomen;
7. hereditary predisposition.

In any case, the pathology requires mandatory and competent treatment. Currently, the only treatment option is surgery. However, in some cases, therapy is practiced without surgery, although it does not guarantee a 100% result.

The treatment regimen is determined by a pediatric surgeon based on the results of examination, tests and hardware diagnostics. It should be noted that a hernia of the linea alba in children responds well to treatment, since the child’s body is resilient and recovers quickly.

The treatment method without surgery is rather supportive and preventive in nature, helping the disease not to worsen.

Non-surgical therapy includes regular wearing of a special bandage, which resembles a wide and elastic Velcro belt. The bandage should support the abdominal cavity and prevent the hernia from growing.

The second stage is strengthening the abdominal muscles with the help of special therapeutic exercises (physical therapy). You only need to do the prescribed exercises. Unreasonable training will lead to worsening or strangulation of the hernia.

In addition, it is very important to take care of your baby’s diet and choose the right diet, which will be aimed at preventing constipation and increased gas formation.

The surgical procedure is called hernioplasty. Usually a planned operation is prescribed, for which the child is carefully prepared. In case of injuries or additional complications, emergency surgery is performed.

Before the procedure, children must be examined by a therapist and cardiologist and undergo the necessary tests. The day before surgery you should not eat, you are only allowed to drink water. Then the baby is given an enema and given an injection, which stops the intestines. In addition, the child is given a sedative so that he gets enough sleep and is not afraid.

The procedure is carried out in two ways:

1. Classic hernioplasty. The surgeon makes an incision and assesses the condition of the internal organs. Puts them in place, sutured the hernial sac. If the pathology is small, the hole is closed with one’s own tissues. The aponeuroses overlap each other for better fixation. This method is dangerous due to possible relapses and suture divergence. If the hernia is large, the surgeon places a special mesh over the hernial opening, which securely closes it.
2. Laparoscopy. Modern minimally invasive technique. Only a few small incisions are needed to insert the laparoscope. The probe has cameras that show the condition of the abdominal cavity and give an overall picture. Advantages: low level of injury, short recovery time, absence of excessive bleeding. However, the operation has a number of contraindications.

An abdominal hernia is a prolapse of abdominal organs through the anterior wall of the abdomen through an existing hole or one formed as a result of pathology, while maintaining the integrity of the anatomical membranes covering them.

Protrusion of the organ is possible under the skin, into the space between muscles, into internal cavities.

A hernia in a child’s abdomen is formed only in the presence of conditioning and fulfilling factors. The first factors include congenital weakness of tendons and muscles and weak points formed due to injury, exhaustion or surgery. The formation of a hernia can be caused by a frequent increase in pressure inside the abdomen, which is likely due to heavy lifting, hacking cough, flatulence, impaired urination, and constipation.

With a hernia of the linea alba, the rectus muscles diverge in the area of ​​the aponeurosis along the midline. Intestinal loops, a small part of the stomach, omentum, and the left lobe of the liver can protrude through this hole. The formation can form above, below or near the navel.

Sometimes hernias due to diastasis are multiple. The defect is very rare, occurring in approximately 0.8% of cases. The cause of the pathology is the underdevelopment of the aponeurosis. Insufficiency of fibers in the linea alba can be caused by genetic predisposition, abdominal obesity, or trauma.

A defect is formed when there is a surge in pressure inside the abdominal cavity, for example, during strong screaming and crying in infancy, during physical stress, constipation, severe coughing, and impaired urination. The pathology is formed in several stages. At the stage of preperitoneal lipoma, preperitoneal tissue falls out through a defect in the fibers.

Next, a peritoneal pocket is formed, inside which there may be part of the intestine, omentum, or stomach wall. Upon final formation, the hernial sac is noticeable and can be easily palpated. Often the hernia does not develop and remains at the first stage, when the protrusion is hidden.

Mechanism of hernia formation

A hernia of the white line of the abdomen appears in the area of ​​the so-called. The white line is a tendon strip that runs from the xiphoid process to the pubic fusion. The linea alba is wider in the upper part of the abdomen and narrows in the lower part, so the risk of a hernia is higher here.

When a hernia appears, the tendon fibers may diverge along the white line by 10-12 cm (diastasis). There is a possibility of diastasis turning into an umbilical hernia.

The shape of the hernial orifice can be round, oval or diamond-shaped. The narrower they are, the greater the likelihood of hernia strangulation. With reducible hernias, palpation of the hernial orifice is possible.

Often, a hernia of the white line is single, but in some cases several hernias are observed, which are located one above the other.

Types of hernias in children and what is their danger

Most often a defect is diagnosed in children in the navel area, the second place is occupied by an inguinal hernia, and quite rarely a hernia of the white line of the abdomen is formed. An uncomplicated hernia does not cause pain and can be freely reduced (with pressure, the hernial sac returns to the abdominal cavity).

A complicated hernia begins to hurt and cannot be reduced. The diagnosis is made after a clinical examination; an abdominal ultrasound and radiography are prescribed to determine the contents of the sac. The danger of a defect in children is the possibility of pinching of the hernial sac, which can result in death of the tissues of the contents (due to poor circulation) and peritonitis.

If a hernia is pinched, urgent surgery is necessary. Removal of a hernia is only possible through surgery. About a third of all operations in pediatric surgery are performed to remove hernias.

Symptoms

Pathology in a child can be determined by certain signs. A hernia may occur immediately after birth or appear after a few days or weeks. In children, there are often cases when several hernial sacs appear, which are usually localized one after another.

• The size of a child’s hernia is usually small: no more than 2-3 centimeters;
• Externally, you can notice a swelling in the abdominal area, which has a round shape. If you press on it, you will feel the soft contents, reminiscent of dough;
• A hernia on the baby’s stomach is especially noticeable when he cries;
• The child feels pain and discomfort in the area where the hernial sac occurs. The nature of the pain is usually aching or pulling. The baby cries often;
• In a supine position, the hernia disappears;
• The baby begins to have problems with the digestive system. Possible nausea, vomiting, frequent constipation;
• If the bladder has been affected by a hernial sac, problems with urination begin.

Diagnosis of abdominal hernia in a newborn

A doctor will be able to accurately diagnose the pathology after an initial examination of a small patient:

• The doctor takes an anamnesis based on the mother’s complaints and examines the baby;
• To make an accurate diagnosis, the newborn must undergo an ultrasound examination of the abdominal cavity;
• A computed tomography scan may be prescribed. But this method is rarely used;
• X-rays of the gastrointestinal tract are prescribed by a doctor to identify complications and study the nature of the hernia. X-rays are performed using a contrast agent, which makes it possible to accurately examine the hernial sac that has arisen.

It is not difficult to determine whether a child has a hernia or not. It is visible upon visual inspection. The main characteristic feature is a protrusion above the navel, shaped like a ball (this is clearly visible in the photo). The size of the ball varies from 1 to 10 cm. If you lightly press on it, it will move into the peritoneum and then protrude again.

With a slight increase in the umbilical ring, the hernia can only be noticed when the abdominal muscles tense when sneezing, coughing, crying or laughing. The color of the skin around the navel changes.

Only a surgeon can determine whether there is a hernia and what treatment needs to be applied. Sometimes the so-called “cutaneous navel” is mistaken for a hernia. Outwardly, it looks like a hernia, but it is not one - it is simply a physiological feature of a particular child.

Children with a hernia are more restless because the bloating and colic typical of babies are more painful. Babies with a hernia are weather dependent: they react to changing weather conditions with whims or, conversely, with lethargy and drowsiness.

Each form of the disease has its own clinical symptoms, as well as indications for surgical intervention.

Fetal umbilical hernias, both true and false, are formed during the period of intrauterine development of the fetus.

A false embryonic hernia is an eventration (prolapse) of the abdominal organs, resulting from underdevelopment of the anterior abdominal wall. This type of umbilical hernia is very rare, approximately 2-3 cases per 7,000 newborns.

When examining a newborn, the liver and loops of the small intestine located outside the abdominal cavity are visible, covered with a thin translucent membrane. When the fetus passes through the mother's birth canal or in the first hours of a newborn's life, this membrane can rupture and then the intestinal loops come out.

True embryonic hernias of the umbilical cord (omphalocele or embryonic hernias in children) are formed as a result of improper development of the peritoneum in the twelfth week of fetal development. They occur with a frequency of 1 case in 4,000 births.

The hernial sac of embryonic hernias has three layers formed by the peritoneum, Vartan's jelly and amnion. The protrusion can have different sizes, ranging from 1-2 cm in diameter to 10 cm or more. Embryonic hernias usually contain part of the liver and intestinal loops in their sac. When the child cries and strains, the protrusion noticeably increases.

The formation of postnatal umbilical hernias occurs after birth and they usually begin to appear clinically at 2-3 months of the child’s life.

The leading symptom of an umbilical hernia in children is the appearance of a small swelling in the navel area, which has an oval or round shape. When the child cries and strains, this swelling increases.

In most children, an umbilical hernia does not cause any discomfort or anxiety. Only when the disease progresses and the hernial protrusion reaches a significant size, the child may experience pain in the umbilical region, constipation, nausea, and cramping abdominal pain.

Umbilical hernias in children are strangulated quite rarely. If strangulation (strangulation, compression) of a section of the intestine occurs, the hernial protrusion becomes irreducible. In this case, a symptom complex of acute abdomen develops:

• severe cramping pain in the abdomen;
• delayed passage of stool and gases;
• severe nausea and repeated vomiting;
• protective tension of the muscles of the anterior abdominal wall (board-shaped abdomen);
• positive Shchetkin-Blumberg sign.

If parents suspect that their child has a hernia, they should immediately visit a specialist who can diagnose the disease. At the same time, there are certain symptoms that will allow you to independently identify pathology in a child even at the initial stage. These signs include:

• An oval or round bulge appears on the child’s tummy, dense and elastic. The hernia is located in the navel area and when pressure is applied to the abdominal muscles, it increases in size;
• the navel protrudes when crying or straining;
• the tumor increases in the first six months;

The disease is diagnosed by a pediatrician or pediatric surgeon. To do this, a small patient is examined and the presence of a seal and the size of the hernia are determined.

Only after a full diagnosis can you begin to treat the hernia with the help of special medications and massage.

Additional diagnostic methods are ultrasound, as well as all mandatory tests.

Signs of an umbilical hernia in children are more often observed from the neonatal period, while inguinal hernia can develop later. Upon examination, a swelling is detected under the skin around the navel or in the groin area.

This formation becomes obvious with an increase in intra-abdominal pressure of any etiology (crying, sneezing, coughing, straining during bowel movements, when the baby is in an upright position). Gentle palpation helps determine the size of the hernial formation.

By gently pressing your finger on the protrusion, it can be reduced. In the lying position and when the child calms down, the hernia disappears. With small hernias that are easily reduced, the child usually does not experience pain, but is characterized by increased excitability, weather dependence, a tendency to increased gas formation and unstable stool.

The symptoms of hernia of the white line of the abdomen in children depend on the stage of development of the pathology. At the first stage, the disease occurs in the form of protrusion of muscles in the umbilical region.

When the child relaxes his stomach or is in a horizontal position, the signs of a hernia become invisible.

In the presence of complications, the protrusion remains in a permanent form and is accompanied by pain. Symptoms of the pathology manifest themselves in the following conditions:

1. Painful sensations in the abdominal area after eating or exercising.
2. Pain in the abdominal area combined with pain in the hypochondrium or lower back.
3. Heartburn, belching and bad breath in combination with the main signs of the disease.
4. Bloating, diarrhea or constipation combined with abdominal pain.
5. Attacks of nausea combined with spasmodic pain in the peritoneum.
6. Protrusion of muscles in the navel area.

Umbilical hernia in children is a common pathology, affecting every fifth child. Premature babies suffer from this disease more often than full-term ones - approximately every third.

Minor defects of the umbilical ring occur in almost all newborns. You should not immediately sound the alarm when you discover a protrusion above the navel. It is important not to make a diagnosis yourself, but if you suspect a hernia, consult a doctor. What kind of disease is this, how to recognize it in time, whether it is necessary to operate on a small patient - we will figure it out in this article.

This is what a hernia may look like

In young children, an umbilical hernia is usually visible to the naked eye. In fact, the main symptom is a protrusion in the navel area, resembling a ball. With gentle pressure on the hernial protrusion, it is easily reduced into the abdominal cavity. If the expansion of the muscle ring is small, then the baby’s umbilical hernia may be noticeable only with some straining (while crying, laughing or coughing).

Such children are more restless than their peers without pathology. There is no baby who does not suffer from colic due to bloating. But children with an umbilical hernia suffer more from them, and they also react more sharply to changes in weather.

Sometimes babies with a hernia experience vomiting, changes in sensitivity in the area of ​​the hernial sac, changes in its color and density. These may be symptoms of a dangerous complication - a strangulated umbilical hernia - and this is a reason to immediately contact a pediatric surgeon.

The main sign of a hernia is a bulge, which causes pain, usually in the epigastric region.

When the hernial sac is strangulated, the following symptoms are observed: severe pain at the site of the hernia, in severe cases - vomiting, fever, general weakness, bloating and peritoneal irritation.

The hernia is very difficult to reduce inside; touching it causes pain. In some cases, a hernia occurs without symptoms and is detected only when the child is examined by a doctor.

Hernia extending into the periumbilical space

In almost one hundred percent of cases, umbilical hernia is detected at an early age. When sick, the hernial sac falls out through the umbilical ring. This defect occurs in 20% of full-term babies and a third of premature babies. Protrusion is more often found in girls under ten years of age.

Under normal conditions in newborns, after the umbilical cord dries, the umbilical ring closes and the opening is covered with connective tissue. Before this process is completed, there is a risk of hernia formation, which means that an increase in pressure in the abdominal cavity can provoke migration of the peritoneum, part of the intestine, and omentum into the umbilical ring.

The main factor in the formation of a hernia is considered to be hereditary insufficiency of the peritoneal fascia. If the parents had this defect, then the probability of formation in the child is about 70%.

Diseases in which the abdomen becomes tense (whooping cough, dysentery, bronchitis, pneumonia, dysbacteriosis, constipation, lactose intolerance, phimosis) can provoke the migration of organs into the umbilical ring, since persistent coughing and straining leads to the fact that the umbilical ring expands even more.

Umbilical hernias in children often occur in infancy (2–3 months). A hernia looks like a formation, a round or oval-shaped protrusion in the navel area (photo below), which increases when the child strains his tummy (during coughing, crying, straining) and becomes smaller or disappears altogether if the baby lies on his back.

Umbilical hernia in a baby

A defective formation does not cause anxiety or discomfort in children, but if it is large, then children may experience pain similar to colic, nausea, pain near the navel, and constipation. In children under 3 years of age, as a rule, spontaneous strengthening of the umbilical ring occurs and surgical intervention is not required.

Incarcerated protrusion is rare. Parents can recognize a dangerous pathology by the enlargement of the hernial sac and a change in its color; in addition, it ceases to be reduced, and the child suffers from nausea, vomiting, bloating, and pain in the umbilical region.

If these symptoms occur, you must immediately go to the hospital, since the pathology can cause obstruction of the intestinal loops and death of its tissues. An umbilical hernia is diagnosed during a routine examination of the baby.

When palpating the abdominal wall, an expansion of the umbilical ring is detected, and when raising the head and body, diastasis and prolapse of organs are clearly noticeable. Additional examination is prescribed only if there is a need for surgical removal of the formation. Children are prescribed an ultrasound, an X-ray of the abdomen, and photographs of the passage of barium through the intestines and herniography are taken.

When treating umbilical hernias in preschoolers, a wait-and-see approach is used, since most often they go away on their own. Measures to strengthen the anterior abdominal wall are recommended: placing the baby on the tummy, massage, swimming, physical therapy.

It may also be recommended to apply an adhesive plaster bandage and wear a bandage to mechanically close the protrusion. Self-healing is also facilitated by adequate physical development of the baby, physical activity, timely treatment of diseases that provoke increased pressure in the abdomen, and normalization of intestinal motility.

If the width of the umbilical ring is no more than 15 mm, then the protrusion disappears on its own by the age of 5–7 years

Indications for surgical removal are large sizes of the umbilical ring, indigestion, strangulated hernia, and also if the protrusion has not disappeared by school age. The operation takes no more than half an hour.

During this time, the surgeon returns the contents of the formation to the abdominal cavity, removes the hernial sac, sutures and strengthens the hernial orifice. No hospital stay is required. In case of emergency surgery, it is necessary to remove the dead section of the intestine with its further restoration.

Causes

The causes of white line hernia in children are usually congenital. The main reason is congenital weakness of connective tissues. Other reasons include gender (hernia occurs more often in boys), obesity, constipation, ascites, chronic bronchitis and whooping cough, postoperative scars, etc.

Abdominal hernia in children often begins to form even before birth.

This phenomenon occurs in the following pathological conditions:

• abnormal course of intrauterine development;
• intrauterine hypotrophy;
• Down syndrome.

The following provoking factors play an important role in the formation of a hernia:

• weakness of the abdominal muscles;
• thinning and excessive elasticity of the peritoneum in some areas;
• hereditary predisposition;
• rickets;
• heavy weight of the baby;
• surgery or abdominal trauma;
• high intra-abdominal pressure (flatulence and stool disorders with a tendency to constipation, frequent crying, coughing of the child).

An umbilical hernial bulge in a one-year-old child may be the result of an overly expanded umbilical ring and severe muscle hypotonia. This is especially common if the child begins to walk and stand early. In this case, there is usually a defect or absence of a section of the peritoneum in the umbilical area, non-closure of the umbilical ring and the umbilical vein located in its upper part is noted.

Inguinal hernial bulge is more common in male infants. Among the reasons for its formation, a large role is played by hereditary predisposition, weakness of the peritoneal fascia, and prematurity. Read more about nursing and development of premature babies →

The development of a hernia of the linea alba in infants and older children can be provoked by congenital characteristics or the influence of certain external factors.

In newborn children, the cause of pathology is constant and severe crying, overeating or constant stress on the abdominal area (for example, when coughing as a result of chronic bronchitis).

With age, the number of provoking factors increases.

The child, while in the mother's womb, is connected to her by the umbilical cord, through which he receives nutrients for formation and growth. After birth, the umbilical cord is tied up and cut off, and the umbilical cord is no longer needed.

Over time, the umbilical ring tightens thanks to the abdominal muscles. Since the umbilical ring in newborns is weak, it sometimes happens that it does not close completely, and this leads to an intestinal loop protruding through it.

An umbilical hernia is a condition in which abdominal organs protrude under the skin through the umbilical ring. Most often, the disease is diagnosed in newborns, but it is also observed in one-year-old children and at 6-8 years of age.

An umbilical hernia can be either congenital or acquired. The following causes of congenital hernia in children are known:

• prematurity;
• genetically determined weakness of the baby's abdominal muscles;
• hereditary factor (pathology more often appears in children whose parents suffered from the same disease in childhood);
• an infectious disease suffered by the mother during pregnancy or an unfavorable environmental situation.

Causes of acquired hernia:

• rickets;
• intestinal colic;
• lactase deficiency.

Sometimes bulging happens for no reason. A hernia in children can also occur in the first year of life (not only in newborns). At this age, complete closure of the umbilical ring occurs, but if the child is bothered by frequent constipation or flatulence, this process may proceed much more slowly.

When diagnosing rickets, doctors warn parents about the likelihood of an umbilical hernia. As a result of this disease, muscle tone weakens, which can lead to a bulge.

In newborns, after the umbilical cord has fallen off, the umbilical ring closes and gradually becomes overgrown (obliterated) with scar-connective tissue. Typically, the lower part of the umbilical ring, which contains the umbilical arteries and urinary duct, contracts better. The upper part, containing the umbilical vein, contracts weakly, since it does not have a muscular sheath.

In the process of strengthening the umbilical ring, the muscles of the anterior abdominal wall, which contribute to its additional contraction, play an important role. With weak tone of the abdominal muscles until the umbilical ring is completely obliterated, an increase in intra-abdominal pressure when coughing, sneezing or straining promotes the release of intestinal loops, omentum, and peritoneum into the peri-umbilical space. Thus, the formation of an umbilical hernia in children occurs due to the weakness of the peritoneal fascia with incomplete fusion of the umbilical ring. The hernial sac for an umbilical hernia in children usually includes loops of the small intestine and the omentum.

One of the main risk factors for the development of umbilical hernia in children is hereditary predisposition. It is known that if one of the parents had the pathology, then the probability of its occurrence in the child is 70%.

Also, risk factors for the formation of a hernial protrusion in a child include diseases and conditions in which intra-abdominal pressure increases, since straining and coughing lead to an increase in protrusion of the peritoneum and even greater stretching of the umbilical ring.

A hernia in young children can occur for several reasons. Some doctors, as well as most parents, are of the opinion that the first symptoms of a hernia in an infant or newborn appear after cutting the umbilical cord and using a clamp. In fact, this opinion is erroneous and does not affect the development of hernial pathology in any way.

In a baby, pathology develops under the influence of several factors and diseases during intrauterine development. The most important reasons include:

• prematurity or difficult pregnancy;
• low weight of the child;
• genetic predisposition;
• congenital abnormality of connective tissue;
• rickets;
• flatulence or frequent constipation;
• constant and prolonged crying in the baby;
• frequent and severe cough;
• pathology of the anterior peritoneal wall.

Each cause has its own symptoms, which will further help determine how to treat the disease and how severe the pathology is in the child. Correct diagnosis will allow you to avoid surgery and cope with the disease using conservative methods. In addition to these reasons, excessive consumption of spicy and smoked foods, smoking, drinking alcoholic beverages or coffee can have a negative impact on the formation of the fetus.

The immediate cause of an umbilical hernia is anatomical weakness of the tissues in the area of ​​the umbilical fossa.

• prematurity;
• low birth weight of the child;
• heredity (the disease more often occurs in children whose parents had an umbilical hernia in childhood);
• conditions that provoke an increase in pressure in the child’s abdominal cavity (excessive crying, constipation, cough, flatulence);
• diseases in which muscle tone decreases (rickets, malnutrition);
• umbilical hernia is more common in girls than in boys;
• sometimes umbilical protrusion appears after the baby begins to walk, especially if this happened early enough (because his muscles are not yet strong enough).

There is an opinion among parents that umbilical hernia in children occurs due to “improper ligation of the umbilical cord,” but this statement is unfounded; The umbilical cord staple technique does not widen the umbilical ring in any way.

• rickets (see also: What are the signs of rickets in children under one year of age?);
• intestinal colic;
• low birth weight;
• constipation, cough, severe crying, flatulence;
• the beginning of walking, especially if the child began to take a vertical position at an early age, and the baby’s muscles are not yet strong enough;
• lactase deficiency.

Why can there be a hernial protrusion in infants? There are several reasons for the occurrence of pathology:

• Genetic predisposition;
• Premature birth and prematurity;
• Insufficient development of connective tissue;
• Rickets;
• Incorrect development of the anterior abdominal wall;
• Weakness of the abdominal wall muscles;
• Consequences of surgery;
• Increased pressure inside the peritoneum due to: prolonged crying or screaming of the baby; overweight and obesity; getting an abdominal injury; persistent cough.

Prevention of hernia of the white line of the abdomen in infants is regular bowel movements and the absence of excess weight. Since constipation and obesity increase the load on the abdominal cavity, care must be taken to ensure that the baby does not overeat and that his intestines work properly. In addition, the baby should not be allowed to burst into tears from screaming.

If the child is older—5–10 years old—the formation of a hernia can be prevented through moderate exercise. Strengthening the abdominal muscles helps to tighten the aponeurosis.

Even if a child is diagnosed with a hernia of the linea alba, this is not a reason to panic. This is not such a terrible disease, and the operation to eliminate it is quite ordinary and safe.

Types of hernia and stages of its development

Proper care of the baby and implementation of preventive measures can prevent the occurrence of an umbilical hernia, even if the muscles of the umbilical ring are weak, and there is still a certain risk of a hernia.

Typically, a doctor observing a child gives parents the following advice (mostly related to the nutrition of mother and child):

• Try to maintain breastfeeding for as long as possible: this will prevent constipation, bloating, and intestinal dysbiosis.
• A nursing mother should not eat foods that cause flatulence in the baby: whole milk, legumes, grapes, cabbage, baked goods and other sweets, smoked meats, nuts, carbonated drinks.
• If breast milk is insufficient or absent, it is necessary for the doctor to select a formula for artificial feeding. An umbilical hernia in childhood often develops with congenital lactose intolerance.
• Protect your child from colds, do not let him cry for a long time, because coughing and crying provoke an increase in intra-abdominal pressure, and, therefore, aggravate the symptoms of a hernia.

Depending on the location of the hernia in relation to the navel, several types of hernia of the white line are distinguished:

• supra-umbilical;
• subumbilical;
• peri-umbilical.

There are three main stages of hernia development:

• preperitoneal lipoma - protrusion of subperitoneal fat.
• the initial stage is the appearance of a hernial sac, into which the internal organs begin to fall out.
• formed hernia - divergence of the rectus muscles and prolapse of certain sections of the walls of the small intestine into the pouch.

Inguinal hernia in a child

An inguinal hernia occurs in 5% of full-term babies and in almost a quarter of premature babies. Often the defect is combined with other pathologies, for example, hydrocele, congenital hip dislocation, connective tissue diseases, and spinal developmental disorders. In boys, the disease occurs up to 10 times more often than in girls, which is associated with the descent of the testicles into the inguinal canal and scrotum.

An inguinal hernia is formed due to the release of internal organs and the parietal layer of the peritoneum through the inguinal canal. In children, this disorder is usually congenital. During normal development in the fetus, after the migration of the testicles, the vaginal process is closed by connective tissue, a violation of this physiological process leads to the formation of a peritoneal pocket.

The hernial sac becomes the vaginal process of the peritoneum, a loop of intestine, part of the omentum, an ovary or a fallopian tube falls into it, and the hernial orifice is a ring of the inguinal canal. Acquired formations are rare and usually develop in boys with weak abdominal muscles and excessive physical activity.

You can notice the protrusion already in a newborn baby. It increases during abdominal tension and disappears with rest. The formation is painless and can be oval or round in shape. With an inguinal-scrotal hernia, the formation can descend into the scrotum in boys (which makes it asymmetrical), and into the labia in girls.

When the hernial orifice is compressed, the internal organs become pinched, which leads to disruption of blood circulation in them and the development of necrosis. Compression can occur due to flatulence, constipation, or increased pressure in the abdomen. Even short-term pinching of ovarian tissue can provoke the death of eggs and necrosis of the organ, so surgical care should be provided as soon as possible.

Inguinal hernia strangulation leads to decreased reproductive function

To confirm the diagnosis, the child must undergo an ultrasound of the abdominal cavity, scrotum, inguinal canals and pelvis in girls; irrigography may be required. An uncomplicated hernia is removed before the child is one year old. During the operation, the hernial sac is cut off and the normal appearance of the inguinal canal is recreated.

Treatment of hernia in children is only surgical, since wearing a bandage and conservative therapy have proven ineffective. Since the defect often has a genetic predisposition, parents who have been diagnosed with hernias should be vigilant.

To prevent the formation of a hernial sac, it is recommended to prevent constipation from infancy, not to allow the child to lift weights or cry for a long time, and try to protect him from diseases, especially those that are manifested by a hacking cough. If a protrusion is detected, you must contact a surgeon.

Diagnostics

At the slightest suspicion, you should contact your treating pediatrician. If necessary, he will refer you to specialized specialists. The diagnosis is complex, combining an oral conversation with the parents and the child (if the baby is talking) to collect an anamnesis and various diagnostic studies:

1. visual examination of the child;
2. auscultation (listening to the area of ​​protrusion);
3. palpation of the abdominal cavity and hernia in particular;
4. laboratory tests (blood, urine, feces);
5. Ultrasound (provides information about the contents of the hernial sac);
6. radiography (shows the overall picture);
7. MRI or CT (if necessary).

A complete diagnosis of white line hernia will help to detect the disease in a timely manner and effectively treat it. Examination of the abdomen is carried out in a horizontal and vertical position of the patient with tense and relaxed muscles of the abdominal wall.

The following methods are used to diagnose the disease:

• examination of the patient;
• interview and history taking;
• auscultation and palpation of the hernia;
• X-ray examination of the stomach;
• Ultrasound of the contents of the hernial sac;
• gastroscopy;
• urine and blood tests;
• MRI and CT scan of hernia (in difficult situations).

Differential diagnosis of white line hernia is usually carried out for the following diseases:

• cholecystitis;
• pancreatitis;
• stomach ulcer;
• tumor metastases to the omentum.

A doctor can make a preliminary diagnosis of a hernia of the linea alba on the basis of a visual examination of the child and palpation of certain areas of the abdominal cavity.

To confirm the pathology, additional examinations and consultations with specialized specialists are prescribed.

Methods for diagnosing the disease are the following procedures:

• palpation of the area of ​​the white line of the abdomen;
• general blood and urine analysis;
• EGDS;
• Ultrasound of the abdominal organs;
• MRI of the abdominal organs;
• X-ray of the stomach and duodenum;
• computed tomography of the abdominal organs;
• herniorrhaphy;
• gastroscopy.

As noted earlier, an umbilical hernia is usually visible upon examination. An experienced pediatrician will detect it and refer the patient to a surgeon to clarify the diagnosis. However, one examination is not always enough, because the protrusion may be invisible due to its small size or have other reasons for its appearance. There are pathologies with similar symptoms, for example, tumor-like neoplasms.

To exclude or confirm the diagnosis, the following studies are additionally performed:

• general blood analysis;
• ultrasound;
• herniography (x-ray examination of the hernial sac);
• X-ray of the stomach and duodenum.

Additional instrumental diagnostics are needed when the results of the examination determine how to treat the child, as well as when making a decision about surgery. In addition, it is necessary to find out if there is any other pathology of the digestive tract.

Diagnosing an umbilical hernia in children is usually not difficult. Palpation of the anterior abdominal wall reveals an enlarged umbilical ring. If you lift the child’s head and torso, the hernial protrusion and the area of ​​divergence of the rectus abdominis muscles become noticeable.

If the question arises about the need for surgical removal of an umbilical hernia in children, then a number of instrumental studies are additionally carried out:

• herniography (x-ray examination of the hernial sac with the introduction of a contrast agent into it);
• radiography of the gastrointestinal tract using barium sulfate;
• plain radiography of the abdominal cavity;
• Ultrasound of the abdominal and pelvic organs.

Diagnosis of embryonic umbilical hernias in most cases is carried out in the antenatal period during an ultrasound examination of the fetus.

Hernia in children: how to identify and treat?

A hernia is a protrusion of an organ or part of it through anatomical canals under the skin, into the space between muscles or into internal cavities (for example, into the chest from the abdominal cavity). A hernia in a child should be diagnosed as early as possible, since this phenomenon can lead to life-threatening complications.

Why do hernias occur, what are they, how do they manifest themselves and why are they dangerous? This is important to know for parents who suspect such a pathology in their baby.

Features of treatment of umbilical hernia in children

This pathology in children is treated both with and without surgery. Treatment tactics are chosen after a joint consultation of a small patient with a local pediatrician and a pediatric surgeon.

What methods will avoid surgery?

Conservative treatment of a hernia of the linea alba in children is prescribed only if the pathology is diagnosed early and there is no tendency for rapid development of the pathology.

Drug therapy is carried out to eliminate additional symptoms.

The child may be prescribed painkillers and anti-inflammatory drugs appropriate for his age.

Such medications do not affect the hernia, but alleviate the general condition.

The treatment method is chosen depending on the size of the hernia. It is often possible to manage with conservative methods without resorting to surgery. This is possible if the protrusion is small and does not increase in size and does not cause discomfort to the child. Usually a hernia is treated in simpler ways.

If the umbilical hernia is small in size, it is treated with conservative methods (massages, gymnastics and medications)

In some cases, the child is treated with medication. The drugs prescribed to the patient are designed to cure the hernia by strengthening the abdominal walls. By adding massage, gymnastics and wearing a bandage to this therapy, you can get good results. If the desired effect is not achieved by 4-5 years, doctors begin to think about surgery.

Massage

Massage is allowed for babies after the umbilical wound has healed, that is, a few weeks after birth. First, you can visit a specialist who will teach your mother how to do this correctly. Over time, mom herself will be able to understand the principle and master the massage technique and do it at home.

Before the procedure, it is necessary to straighten the protrusion and carefully cover it with a plaster. This is necessary to ensure that the hernia does not fall out during the massage. All actions during the massage should be soft, gentle, light. Do not press on the baby's tummy.

First, stroke around the navel clockwise, then counterclockwise. Afterwards, the oblique muscles are massaged to strengthen the walls of the abdominal cavity. Here the movements become more intense. Then again circular stroking. Next - light tingling in the navel area and stroking again.

The whole procedure lasts no more than 3-5 minutes. You need to repeat it several times a day and always before meals. Daily massage will give positive results.

Physiotherapy

For the little ones, use the following exercises:

• Before each feeding, the baby is placed on his tummy for a few minutes;
• turn the child over on the left side, then on the right side for a few seconds;
• holding the baby facing you, tilt him back, holding his head so that he does not tip back;
• from a supine position, lift the child by the arms, supporting him under the back (while the head and legs hang freely);
• do rollovers from back to stomach;
• Place the baby with his back on a large ball and roll, holding him by the legs.

Older children undergo a course of physical therapy, including physical and gymnastic exercises designed to strengthen the muscles of the abdominal wall. It is recommended to train at least 2-3 times a week. Physical therapy is a great way to remove a belly button mass.

As a complex treatment, together with massage and gymnastics, a special fixing patch and bandage are used. A patch that allows you to remove an umbilical hernia in a baby is used after the umbilical wound has healed. It is glued to the navel so that a fold is formed and worn for 10 days. The course is repeated several times with short breaks.

Plaster and bandage for umbilical hernia

The main thing is that the patch is made of hypoallergenic and breathable material. Babies' skin is very sensitive and an allergic reaction may occur.

The bandage is worn to prevent strangulation of the hernia. When wearing this accessory, the walls of the abdominal cavity are strengthened and the umbilical ring is reduced, which leads to recovery.

If the doctor insists on the need for surgery, you should not ignore his advice. In what case is a hernia operated on? This happens if:

• umbilical ring size more than 2 cm;
• a strangulated hernia appeared;
• a hernia in a baby over 1 year old increases in size;
• protrusion does not go away in a child until 4-5 years of age.

When the hernia is small, during surgery the doctor makes an incision above the navel and tightens the umbilical ring. The operation lasts no more than 20 minutes.

For a large hernia, hernioplasty (hernia repair) is performed - the hernia is surgically removed. During the operation, the hernia is first reduced, then a synthetic mesh is placed on the hernial orifice according to the principle of a patch, which over time grows into the tissues of the body and prevents the reappearance of the protrusion.

It is known that in some cases a hernia can disappear on its own. It is for this reason that doctors leave the formation under observation for a period of 5–6 months. If after this time the signs of a hernia in the child remain, the doctor will prescribe one of the treatment methods, depending on the severity of the pathology. The main methods include:

• conservative treatment;
• surgical intervention.

Conservative methods can be understood as treatment methods such as: massage procedures in the abdominal area or for general purposes, frequent placement of the child on the stomach and a course of exercise therapy.

As the main massage technique, it is worth noting such a method as stroking the tummy clockwise. Parents should perform a similar massage daily, before meals. After eating, the baby should be petted on the tummy for at least 10 minutes. It is advisable for the child to be on a hard surface, and laying the baby out should be accompanied by a light massage. This method is effective in combating small tumors.

A hernia in a child can be treated with a special bandage or patch. The width of such a bandage should be 4 cm. The patch is applied for 10 days, and after this period, if the pathology has not disappeared, it is removed. For hernias, it is allowed to use this patch three times for 10 days. As a result of this course, the hernia goes away quickly, however, it is important to understand that it is not suitable for every child, since the baby may develop skin irritation.

Hernia in children can be cured using folk recipes.

Before using any of the methods described below, you should consult your pediatrician.

In addition to these methods, some parents speak well of such a remedy as sulfur for hernia for newborns. This material works quite effectively, although it is taken orally. The drug can be ordered at any pharmacy.

Massage

What can you do

Self-reduction of a hernia is prohibited for a baby. If signs indicating a possible hernial sac appear, the mother should consult a doctor.

After the prescribed treatment, parents must adhere to the recommendations and prescriptions of the specialist. Doctors recommend placing a baby with an umbilical hernia on his stomach.

After surgery, parents should also follow the doctor's instructions.

What does a doctor do

If the child's hernia is small, the doctor may prescribe conservative treatment. The baby needs to take medications and undergo regular examinations. Massage and physical therapy are prescribed. Your doctor may prescribe the use of a special patch or bandage.

In rare cases, when the hernial protrusion in an infant is large, surgical intervention is performed. The operation is performed under general anesthesia. During surgery, the hernial sac is opened, its contents are removed and the muscle separation is eliminated.

Surgery can be performed in two ways:

• The method of suturing the abdominal walls using the body’s own tissues and a synthetic non-absorbable thread. This method can lead to relapse due to subsequent stress on the sutures.
• The introduction of a special polymer mesh that prevents the re-formation of the hernial sac. This method is more effective. The polymer mesh is not perceived by the child's body as a foreign body and easily takes root. A special frame prevents re-divergence of muscle tissue and eliminates the possibility of relapse of the disease.

The operation to eliminate an abdominal hernia in a newborn is not considered difficult. Usually he is discharged from the hospital within a few days, and after two weeks the surgical stitches are removed.

Postnatal umbilical hernias in children are prone to self-healing, so in this case, expectant management is justified. To strengthen the abdominal muscles, it is recommended to place the child on his stomach more often; swimming in the pool, physical therapy exercises, and massage are also recommended.

In some cases, the doctor may prescribe conservative treatment, consisting of wearing a bandage or applying an adhesive bandage, which provide mechanical closure of the umbilical ring defect and thereby prevent its further expansion.

Varieties

Any hernia has the following components:

• hernial orifice - a hole in the abdominal wall or diaphragm;
• hernial sac - a section of the peritoneum that has passed through the hernial orifice;
• hernial contents - what is in the hernial sac.

Hernias are classified according to several criteria:

• According to the time of formation. Congenital - the diagnosis is obvious already at birth, acquired - the pathology develops as the baby grows older.
• By location. Hernia on the abdomen of a child (abdominal hernia). Its varieties are inguinal, umbilical, and hernia of the white line of the abdomen. In addition, a distinction is made between diaphragmatic and intervertebral localization of hernial formations.

Umbilical

A navel hernia in a child is the most common. A peri-umbilical hernia in children is a consequence of the release of an intestinal loop or part of the omentum through the dilated umbilical ring into the subcutaneous space.

Inguinal

A hernia in a child’s groin is formed when the closure of the inguinal canal is disrupted, which normally occurs at the age of 6-7 months after the testicles descend from the abdominal cavity into the scrotum. If the inguinal canal remains open, loops of intestine can fall through it under the skin or descend lower, down to the scrotum. In girls, the pathology is rare - with anomalies in the structure of the pelvic and groin organs.

Features of hernial protrusions in the groin:

• According to localization, the hernia can be inguinal or inguinal-scrotal;
• bilateral (less often) or unilateral formation;
• according to the degree of severity - incomplete (does not extend beyond the inguinal ring) and complete (extends beyond it and spreads along the spermatic cord);
• hydrocele and spermatic cord cyst are often observed as concomitant diseases.

In a child, a hernia of the white line of the abdomen is often combined with an umbilical hernia. Supraumbilical hernia in children is a consequence of weakness and hypotension of the anterior abdominal wall. With an increase in intra-abdominal pressure, a defect in the abdominal aponeurosis is formed and separation of the abdominal muscles occurs. A white abdominal hernia forms in children, which can be located above or below the navel.

Intervertebral

A hernial bulge of this location is rarely observed at birth. It develops in children due to physical overload, after spinal injuries, or due to abnormalities in its structure. In this case, the cartilage located between the vertebral bodies is squeezed out. More often, such a hernia is localized in the lumbosacral region.

Diet for hernia

Compliance with a special diet is an integral part of the treatment of a hernia of the white line of the abdomen at any stage and during the rehabilitation period after surgery.

Meals should be balanced and fractional. Starvation and overeating of the child must be excluded. The diet must include foods rich in vitamins and beneficial microelements.

1. The last meal should be taken no later than three hours before bedtime.
2. The diet should not contain foods that can cause flatulence (grapes, white bread).
3. Cheeses, seafood, and lean meats will help replenish the calcium supply in a child’s body.
4. The menu should include fermented milk products and natural yogurt with a minimum percentage of fat content.
5. Flour products should be consumed in limited quantities.
6. The consumption of carbonated drinks is excluded.
7. Sweets in a child's diet should be present in minimal quantities.
8. The child’s menu should include fruit jelly, jellies, and natural juices.
9. Spicy, smoked, fried and fatty foods are excluded.
10. The diet should include porridge, light soups and broths.

Why is a hernia dangerous?

Any hernia is dangerous due to the possibility of strangulation. As a rule, this leads to the development of peritonitis. Only emergency surgery can save a child's life.

Why is an umbilical hernia dangerous in children? Cases of strangulation of the hernial bulge of this localization are rare, but dynamic monitoring and consultation with a specialist are required if the baby’s condition worsens. If self-healing does not occur and parents reject surgical intervention, a large hernia may form in adulthood, especially in women after childbirth.

Large hernial protrusions are often strangulated, which leads to emergency surgery.

The danger of a hernia in the groin area, in addition to strangulation, lies in the pressure on the pelvic organs. Subsequently, the processes of spermatogenesis in boys and gestation in girls are disrupted. A herniated disc can cause compression of the nerve roots, which is accompanied by severe pain and limits movement. Sometimes there is difficulty urinating and defecating.

When an umbilical hernia is strangulated, the child may experience the following symptoms:

• vomit;
• nausea;
• blood in stool;
• inability to reduce the hernia with pressure while lying on your back.

In the presence of an umbilical hernia, nausea and vomiting are common symptoms in a child.

A complication in the form of a rupture of the hernial sac, in which its contents come out, is extremely rare. Strangulation and rupture of the hernia are life-threatening, so you must immediately contact a surgeon.

Possible consequences and complications

Lack of medical care is dangerous due to serious complications:

1. Hernia injury. Swelling and inflammation of the hernial sac develops, which spreads to the entire abdominal cavity.
2. Lack of ability to straighten. An adhesive process develops between the skin, hernial sac, peritoneal wall and internal organs.
3. Pinching. Compression of the bag leads to disruption of normal blood circulation in this area. The organs in the hernia gradually die, necrosis and gangrene begin.

How dangerous is a hernia for an infant?

• The most common consequence of the pathology is strangulated hernia. In newborns, this phenomenon is common, but not dangerous. In some cases, pinching can cause harm to the baby. The organs located in the hernial sac are compressed and cease to function fully. If a child suffering from an abdominal hernia experiences sharp, severe pain, this may indicate strangulation. In this case, surgical intervention is necessary as soon as possible;
• The hernia may be irreparable. That is, the contents of the hernial sac are not pushed back into the abdominal cavity. This complication does not cause pain in the child, but may cause minor discomfort. If the child begins to strain, the irreducible hernial sac begins to increase in size;
• A hernia can cause the development of coprostasis. This is obstruction of stool in the intestines. This complication can occur in children who often suffer from constipation. Symptoms of coprostasis appear slowly. The child cannot go to the toilet for a long time, he experiences nausea and vomiting, and feels a general malaise. In this case, conservative treatment is prescribed using massage, an enema or a bowel movement probe;
• If the contents of the hernial sac become infected, inflammation of the hernia begins. It is necessary to remove the source of infection;
• Tuberculosis of the hernia is considered a rare complication;
• The hernial sac may contain foreign bodies, including worms;
• Tumors of the hernia and adjacent tissues may occur.

The main complication of a hernia of the white line of the abdomen is its strangulation, in which the hernial contents are suddenly compressed in the hernial orifice.

Another complication of a hernia of the white line of the abdomen is the irreducibility of the hernia. In this case, the contents of the hernia are connected to the walls of the hernial sac.

In addition, injury and inflammation of the internal organ located in the hernial sac, as well as intestinal obstruction, are possible.

An advanced form of hernia of the white line of the abdomen can cause serious infringement or necrosis of certain internal organs.

Compression of the intestine or omentum impairs blood circulation, resulting in a risk of developing peritonitis.

If this pathology is detected in a child, it is necessary to treat the disease or perform surgical intervention as soon as possible.

A hernia of the linea alba can cause the following complications:

• rupture of an internal organ damaged by a hernia;
• development of peritonitis;
• intestinal obstruction;
• development of an inflammatory process or suppuration.

Why is a hematoma on the head of a newborn after childbirth dangerous? Find out the answer right now.

The most complex degree of pathology is such a complication as strangulation of the umbilical hernia. This disorder is not common in newborns, however, parents need to know what to do with their child in such a situation and how to cure this disease. To understand what disease your baby has, you should pay attention to the signs:

• the child cries often and loudly;
• the baby behaves restlessly;
• the baby often refuses to eat;
• in the navel area there is redness or pallor of the epidermis;
• the neoplasm protrudes and the hernia can be identified visually;
• the baby may vomit

If such symptoms are observed in a child, then parents should prepare for surgery. Only surgical intervention will solve a serious problem. In particular, such a violation can lead to tissue necrosis, and subsequently to very serious consequences.

The most dangerous complication of an embryonic hernia of the umbilical cord is rupture of the membranes that form the hernial sac. As a result, an infection enters the abdominal cavity, leading to the development of diffuse peritonitis.

Strangulation of a postnatal umbilical hernia in children is accompanied by necrosis of a section of the intestine and the development of mechanical intestinal obstruction.

Hernia prevention

To prevent the formation of umbilical hernias in children, measures aimed at strengthening the muscles of the anterior abdominal wall (laying on the stomach, exercise therapy, massage, swimming) are recommended. In addition, it is necessary to promptly identify and actively treat diseases that weaken the muscles of the anterior abdominal wall or increase intra-abdominal pressure (rickets, pneumonia, whooping cough).

To prevent a hernia of the linea alba in infants, regular bowel movements should be performed. You should also ensure that the baby does not overeat and that his intestines work reliably.

For children aged 5-10 years, moderate physical exercise is an effective prevention of hernia formation.

It is necessary to regularly take the child for routine examinations to the doctor and accustom the child to moderate hardening.

In conclusion, it should be noted that a hernia of the linea alba in children can only be eliminated through surgery. It is very important to carry out diagnosis and surgery in a timely manner, otherwise complications are possible, first of all, strangulation of the hernia. But even after the operation, careful adherence to all doctor’s recommendations is necessary to prevent relapses.

Is it possible to prevent a hernia in a baby? From the first days of a child’s life, parents must adhere to certain measures to prevent pathology:

• The child needs proper and nutritious nutrition. The first months of life are breast milk or high-quality formula;
• Avoid constipation and excess weight gain;
• Parents should calm the baby down when crying begins, so that he does not overstrain himself from screaming;
• Parents should place their newborn on his stomach frequently.

The main measure to prevent a hernia of the linea alba in children is to follow a diet and avoid exposure to negative factors. In a newborn or infant, the abdominal muscles are weak.

Prolonged coughing or crying has an extremely negative impact on them.

Any sprain or injury can trigger the formation of a lipoma, which gradually turns into a hernia.

The following recommendations help prevent the development of pathology:

• exclusion of excess weight in the child;
• preventing constipation;
• avoiding fasting and overeating;
• strengthening the abdominal muscles with a set of special physical exercises.

If you suspect that a child has developed a hernia of the linea alba, you should consult a doctor as soon as possible. An alarming signal is the appearance of muscle protrusion in the umbilical region. This symptom can be a sign not only of a hernia, but also of other serious pathologies.

Strangulated hernia

It is an absolute indication for surgical intervention. Moreover, within several hours, the bulge in the groin or abdominal wall cannot be reduced, which was previously easily done by the parents. Attempts to do this cause pain and increase the child’s anxiety.

Such phenomena indicate that the formation is compressed in the hernial canal. There is a threat of developing peritonitis due to necrosis of the strangulated intestinal loop. Therefore, a strangulated hernia is an emergency.

Danger signs are:

• Significant increase in size of the hernial formation.
• Redness and increased temperature of the skin over the hernial sac.
• A sharp deterioration in the child’s condition (vomiting, fever, stool retention, severe anxiety).

If the parents' attempts to correct the situation are unsuccessful within several hours, the child's condition is still poor, it is necessary to call an ambulance. Under no circumstances should you use painkillers or antipyretics, as this can lead to serious complications.

What to do?

Hernia of the white line of the abdomen in children, as well as hernial bulges of the abdomen of other localization, are an indication for the need to strengthen the abdominal wall. To do this, the baby must often be placed on the tummy before feeding; therapeutic exercises and a tonic massage are needed. Read more about massage for children with umbilical hernia →

Parents should monitor the size and condition of the hernial bulge when bathing and swaddling the baby. At the slightest deterioration of the condition, urgent medical consultation is needed.

Removal of an inguinal hernia in a child can be performed routinely or for emergency reasons. If the hernial bulge is small, parents usually successfully correct it themselves; this does not cause concern to the child. In this case, the operation is planned after the baby reaches one year of age.

If the hernia often protrudes, its consistency gradually becomes thicker, touching it becomes painful, and reduction is difficult, this is an indication for urgent medical consultation. With such dynamics of the disease, surgery should be performed at any age. Suspicion of infringement is a direct indication for emergency surgery.

An umbilical hernia rarely leads to health-threatening complications. Usually, as the child grows older, the size of the protrusion decreases, self-healing occurs, as the tone and strength of the muscles of the anterior abdominal wall increases.

Sometimes, to speed up this process, mothers practice tightly swaddling the baby's tummy or try to strengthen the abdominal wall with a bandage. These activities can lead to compression of internal organs and inflammation of the skin, so you should first consult a doctor. If sealing is necessary, only a hypoallergenic adhesive plaster can be used.

Elective herniotomy is resorted to at the age of 3-7 years, if spontaneous closure of the umbilical ring does not occur. In girls, surgery is performed to prevent complications during pregnancy.

If a child often complains of back pain, especially after a spinal injury, an MRI is necessary to clarify the diagnosis. If a spinal hernia is detected, the doctor will prescribe conservative treatment - NSAIDs, vascular and vitamin preparations, massage, exercise therapy, physiotherapy. If necessary, surgery is performed.

Hernia in children is a common pathology that can develop at any age. If warning signs appear, an urgent medical examination is necessary to select effective treatment. It is impossible to ignore the disease in order to avoid a threat to the health and life of the child.

There are topics and problems that cause parents great concern for their child. One of these issues is abdominal hernia in children. This disease is a protrusion of the abdominal organs, which are located in the hernial sac. They protrude through a defect - an opening, which doctors call the hernial orifice.

Hernial orifices or protrusions begin to form only in those places that are weaker than others. These include the groin area, the area near the navel, and the white line of the abdomen.

Causes of the disease

Photo: umbilical hernia in a newborn

A hernia in a child can occur due to a genetic predisposition if, after birth, the abdominal walls do not develop correctly. Also, a hernia can be acquired due to anatomical weakness.

All this leads to tissue depletion and loss of their former elasticity. They are not able to cope with the loads exerted, so round or slit-like holes begin to form.

The most common cause of the development of abdominal hernia in children is underdevelopment of the tendon plate, which includes collagen fibers and tissues responsible for the elasticity of the peritoneum.

There are also frequent cases when the disease is provoked by increased intra-abdominal pressure. The following factors contribute to this:

• Overweight child, in rare cases even obesity;
• Abdominal injury. A hernia may begin to develop in places where the surgical suture was previously located;
• Prolonged crying of the baby, chronic bronchitis or whooping cough.

Stages of development of hernial protrusion

Most often, a child experiences a hernia of the linea alba. There are three stages of its development:

1. The first stage is characterized by the protrusion of peritoneal cells through the opening, which is still small in size. A lipoma is formed located in front of the peritoneum. Basically, in children at this stage, the development of a hernia stops;
2. When the lipoma begins to form into a hernial sac, the second stage of the disease begins. The sac contains the omentum and small intestine. An already formed hernia forms a portal for exit. In complicated cases, the walls of the stomach are located inside the hernial sac;
3. The third stage of the disease is visible to the naked eye. It is easily detected by palpating the abdominal area. The hernial sac begins to fall out.

Features of the appearance of hernias in children

The peculiarities of the appearance of hernias in a child include the fact that they are local only in rare cases. Often several hernias form at once, which are located one after another. They can be near, under or above the navel.

In children, hernias are not large. Usually its parameters do not exceed two centimeters. In appearance, it looks like a small round-shaped swelling; you can view the photo for reference.

Symptoms of abdominal hernia in children

Signs of an abdominal hernia in children include pain, discomfort and the presence of a protrusion, which may disappear when lying down. If such symptoms occur, then you definitely need to visit an experienced doctor. Only he will confirm or refute the diagnosis and prescribe the necessary treatment.

Symptoms of a hernia vary depending on the location and degree of development. However, several important signs have been identified, which include:

• Aching and nagging pain at the location of the hernia;
• Poor functioning of the digestive system. Nausea accompanied by vomiting and frequent constipation are observed;
• Problems with the urinary system. This is possible if the bladder gets into the hernial sac.

If such symptoms are observed, you should immediately consult a doctor!

Diagnostics. Preparing for treatment

Every mother should be wary if her child constantly has a stomach ache. When the pain does not go away, but only gets worse, you need to visit a doctor. Only he will be able to properly examine the little patient, and then, if necessary, refer him for examination.

In addition to palpation, an abdominal hernia can be diagnosed using ultrasound and computed tomography of the peritoneum. The doctor may also perform an X-ray of the gastrointestinal tract. During the final examination, a special substance will be injected into the peritoneum, which will allow a thorough examination of the hernia.

If the diagnosis has been confirmed, then it is necessary to immediately set up the child for surgery. If a hernia was detected in a baby, the date of surgical intervention will be postponed.

On average, most clinics undertake to operate on children over five years of age. However, it will be necessary to undergo a thorough examination by a doctor, who may postpone the treatment period or, conversely, shorten it.

To prepare your child for surgery, you will need to create a proper and balanced diet, excluding some foods from it. These include:

• Spicy and fatty dishes, food with added herbs and spices;
• Chocolate, lemonade, butter;
• Snacks, semi-finished products.

You need to feed your baby five times a day in small portions to avoid problems with the digestive system.

Operation

Surgery to remove an abdominal hernia in children is called hernioplasty. The operation will be performed under general anesthesia, but with a lower dosage. Hernioplasty can be performed using two methods:

• By stitching the peritoneal walls using your own tissues;
• Carrying out an intervention using a specially designed mesh.

During the operation, the surgeon makes small incisions and then opens the hernial sac. He removes its contents, then works to eliminate the discrepancy of the rectus muscles. This allows you to avoid the progression of diastasis. Only this will guarantee a complete cure for the hernia.

When performing hernioplasty with native tissues, the aponeurosis defect is eliminated using a non-absorbable thread made of synthetic materials. This form of intervention can lead to relapse, because subsequently there is a large load on the sutures.

Therefore, surgery during which synthetic materials are used has become more widespread. The mesh frame covers the aponeurosis, which leads to an even distribution of the load on the peritoneum. At the same time, the possibility of relapse is minimal, since the tissue can quickly and easily grow through the allomaterial.

Features of surgical intervention (hernioplasty):

• The operation lasts no more than an hour;
• The next day the child can go home, complications are no longer observed. Only in some cases may the doctor leave the patient for a few more days for ongoing examination;
• Sutures are removed after two weeks.

Rehabilitation period

After the operation, a rehabilitation period begins. During this time, it is necessary to adhere to proper nutrition and also avoid physical activity and heavy lifting. As before the operation, the child is advised to avoid fried, spicy and smoked foods. To facilitate the digestion of food, you should try to eat liquid foods: porridge and soups.

To restore the body after surgery, it is necessary to consume vitamin B and C complexes.

How to prevent a hernia?

To prevent a hernia from developing in infants, it is necessary to achieve constant and regular bowel movements and the absence of excess weight. It is worth taking care that the baby does not overeat or cry for a long time.

If the child is between five and ten years old, then the development of a hernial protrusion can be prevented through moderate exercise. Thanks to them, the abdominal walls are significantly strengthened.

Price

Prices for hernia removal are quite reasonable. They vary in different clinics and depend on its prestige, the professionalism of doctors, the quality of the equipment and instruments used. On average, the cost of an operation to remove an abdominal hernia in a child is from 32,000 rubles. This price includes preliminary examinations.

Last article updated: 04/21/2018

A significant number of parents are familiar with infant umbilical hernia firsthand. This topic is surrounded by many disputes and misunderstandings. When a hernia occurs and part of the internal organs comes out, people often use traditional methods and the healing power of healers, ignoring the traditional methods recommended by doctors and surgeons. But in order to choose the best method for getting rid of your child’s health problems, you must understand what a hernia is and what caused this problem.

Pediatrician, gastroenterologist

A hernia is a defect in the muscle layers in various parts of the body, resulting in protrusion of internal organs.

A hernia appears as a bulge or lump under the skin, usually near the groin or abdomen in infants. Size may vary depending on body position and movement. Based on location, newborns may have either an umbilical hernia (occurs around the navel) or (found in the groin).

An umbilical hernia in a baby occurs when part of the intestine comes out through a hole around the umbilical cord area.

As you know, the fetus in the womb is connected to the mother through the umbilical cord, which must be cut after birth. However, the child still has a small hole in the abdominal muscles. Sometimes this layer of tissue does not close completely, allowing a small portion of the intestine to protrude, thus creating an infantile umbilical hernia.

Heredity is the main cause of pathology. If mom or dad had problems closing the umbilical ring in early childhood, there is a high probability that the child will also encounter this pathology.

Mothers often blame doctors for incorrectly cutting the umbilical cord, thinking that this causes the development of a hernia. But the actions of specialists are not related to the weakness of the abdominal muscles, and it is because of this that bulging of the abdominal organs occurs. Therefore, such a conclusion can be considered fundamentally incorrect.

Babies born prematurely or at low birth weight initially have weak abdominal muscles and connective tissues. These children often experience prolapse of organ parts.

But strong and healthy children can also develop this pathology. As a rule, this does not happen immediately, but is detected in the first year of life. The reasons may be:

• frequent continuous crying;
• persistent cough;
• persistent constipation;
• regular flatulence.

An umbilical hernia in newborns is easily recognized because it is very noticeable. You will see a bulge around the navel area. Of course, a baby's belly button is not like an adult's belly button because the umbilical cord has just been cut. But the difference between a normal navel and a navel with a hernia is usually quite noticeable.

To distinguish a hernia from simple swelling due to the umbilical cord, pay attention to the skin. If it is stretched and tense, it is most likely a hernia.

However, an umbilical hernia may not be noticed until the part of the umbilical cord attached to the baby falls off. In addition, its size may change. Sometimes the hernia will be as large as the swelling, but in some cases it will be more difficult to see.

Sometimes a hernia is visible only when the baby has a tense abdomen, and it remains invisible when the abdomen is relaxed.

If you suspect your baby has an umbilical hernia but are not sure, watch the navel area when your baby cries or strains.

An umbilical hernia usually doesn't cause painful symptoms unless there is some complication, so don't worry about your baby suffering.

An umbilical hernia rarely causes complications. But parents should be aware of the possibility of a strangulated hernia. It occurs when the contents of a hernia become “stuck” and cannot be released back into the abdominal cavity.

When this happens, the blood supply to the pinched area is disrupted. And this is already an emergency situation.

If you see following symptoms, call emergency medical assistance:

• pain in the hernia area;
• discoloration (blanching) of the hernia;
• a hernia that does not return back into the abdominal cavity when the child is relaxed;
• a hernia that looks different than before.

Diagnostics

The diagnosis of “umbilical hernia” is made after comprehensive examination:

• physical examination by a qualified pediatrician;
• careful study of medical history;
• it is important to recognize the signs and symptoms of obstruction and ischemia (poor blood supply) of the intestine in umbilical hernias;
• Imaging techniques will be required to identify any complications.

Many clinical conditions may have similar signs and symptoms. The doctor will perform additional tests to rule out other clinical situations in order to arrive at a final diagnosis.

How to treat an umbilical hernia in a child?

Usually, when there is an umbilical hernia in children, special therapeutic treatment or surgery is not required.

In infants, the protuberance with a diameter of less than one centimeter is tightened by strengthening of the abdominal muscles at the age of 2 - 4 years. But even large defects can heal on their own with the help of simple gymnastics and massage to strengthen the abdominal muscles.

Regardless of the size of the hernia, a visit to a pediatrician or surgeon is included in the mandatory program. Only a doctor will be able to determine the degree of bulging of organs and the prospects for tightening the umbilical cord. The doctor will prescribe the necessary set of exercises and procedures.

Proper medical care is important to treat and prevent infant umbilical hernia.

Sometimes the doctor can push the hernial sac back into the abdomen. It is only important that this is done by a competent specialist.

Massage for umbilical hernia in a child

Massage is an effective and safe method of combating pathology in infants. It is enough to massage your baby's tummy clockwise every day. Advice. Perform stroking movements smoothly, without sudden jolts. Then proceed to light spring pressure with your fingertips.

A positive effect will appear after a month of regular massage. In addition, the baby must be placed on his stomach every day. This helps reduce intra-abdominal pressure, release gas, and increase motor skills of the child’s legs and arms. In general, this pose trains and strengthens the muscles of the anterior abdominal wall.

For older children, the same massage is performed, with the only difference being that the movements can be performed more intensely.

Starting from the age of four months, you can do gymnastics. But to choose the optimal set of exercises, you need to contact a specialist in physical therapy.

Umbilical hernia bandage for newborns

In addition to using measures to build up the abdominal muscles, the surgeon may recommend wearing a special umbilical hernia bandage for newborns.

This product is intended to help in the treatment of pathology:

1. A children's umbilical hernia bandage holds the baby's belly and prevents the protrusion from increasing during severe crying, gas, and persistent pain.
2. A dense, breathable belt, adjacent to the stomach, additionally activates the muscles and seems to train them.
3. The bandage is recommended to combat an already protruding hernia, as well as to prevent its development when the muscles in the umbilical ring are weak.
4. In the center of the belt there is a seal that pushes the hernia inside the abdomen. This promotes the placement of organs in the correct position.

Contraindications

1. The bandage cannot be worn if the baby’s hernia is already pinched. This requires emergency surgery.
2. A newborn whose umbilical wound has not healed should not wear a bandage.
3. The bandage is not recommended for use on infants prone to diaper rash and allergies. Friction of dense matter can aggravate existing skin problems in a newborn.

The bandage itself will not cure a childhood hernia. Exclusively in combination with massage, swimming, and gymnastics, it will be possible to build and strengthen the abdominal muscles. To allow the baby's skin to breathe, the belt must be removed every 3 to 4 hours.

Surgical operation to remove an umbilical hernia in children

It is recommended that it is better and more beneficial to wait until the umbilical hernia closes on its own. This happens as the baby grows and the abdominal muscles strengthen, naturally closing the hernia. This usually happens at 3 or 5 years, if not earlier.

• the hernia does not disappear until 5 years;
• pinching occurs;
• The hernia is very large and therefore unlikely to close on its own.

If your child requires abdominal surgery for another reason, the surgeon may repair the umbilical hernia during this surgery.

Surgical removal of an umbilical hernia is performed under general anesthesia. The surgeon makes a small incision under the belly button and closes the hernia with stitches.

After surgery there will be no stitches that need to be removed because they will be under the skin and will dissolve on their own. Your child's incision will be covered with small bandages. The possibility of a hernia recurrence is very low.

Complications are rare, but can occur.

Contact your doctor if you experience the following symptoms in a child:

• infection (redness, swelling, soreness) at the wound site;
• hernia recurrence;
• headache;
• numbness in the legs;
• nausea.

Caring for a child after surgery

1. Pain: Most children only need it for pain relief. These medications should be taken only when needed and given every six hours.
2. Dressings: You can remove the dressing 48 hours after surgery.
3. Swelling: There will be swelling in the area of ​​the incision. You will feel a tight cord under the incision that lasts for several months.
4. Bathing: The child can be bathed 2 days after surgery.

To prevent hernia complications, you need to provide your child with the right diet, sleep schedule and make sure that the child is in a comfortable and relaxed environment.

A hernia is a protrusion of an organ or part of it through anatomical canals under the skin, into the space between muscles or into internal cavities (for example, into the chest from the abdominal cavity). A hernia in a child should be diagnosed as early as possible, since this phenomenon can lead to life-threatening complications.

Why do hernias occur, what are they, how do they manifest themselves and why are they dangerous? This is important to know for parents who suspect such a pathology in their baby.

Any hernia has the following components:

• hernial orifice - a hole in the abdominal wall or diaphragm;
• hernial sac - a section of the peritoneum that has passed through the hernial orifice;
• hernial contents - what is in the hernial sac.

Hernias are classified according to several criteria:

• According to the time of formation. Congenital - the diagnosis is obvious already at birth, acquired - the pathology develops as the baby grows older.
• By localization. A hernia in a child's abdomen (abdominal hernia). Its varieties are inguinal, umbilical, and hernia of the white line of the abdomen. In addition, a distinction is made between diaphragmatic and intervertebral localization of hernial formations.

Umbilical

A navel hernia in a child is the most common. A peri-umbilical hernia in children is a consequence of the release of an intestinal loop or part of the omentum through the dilated umbilical ring into the subcutaneous space.

Inguinal

A hernia in a child’s groin is formed when the closure of the inguinal canal is disrupted, which normally occurs at the age of 6-7 months after the testicles descend from the abdominal cavity into the scrotum. If the inguinal canal remains open, loops of intestine can fall through it under the skin or descend lower, down to the scrotum. In girls, the pathology is rare - with anomalies in the structure of the pelvic and groin organs.

Features of hernial protrusions in the groin:

• According to localization, the hernia can be inguinal or inguinal-scrotal;
• bilateral (less often) or unilateral formation;
• according to the degree of severity - incomplete (does not extend beyond the inguinal ring) and complete (extends beyond it and spreads along the spermatic cord);
• hydrocele and spermatic cord cyst are often observed as concomitant diseases.

Hernia of the white line of the abdomen

In a child, a hernia of the white line of the abdomen is often combined with an umbilical hernia. Supraumbilical hernia in children is a consequence of weakness and hypotension of the anterior abdominal wall. With an increase in intra-abdominal pressure, a defect in the abdominal aponeurosis is formed and separation of the abdominal muscles occurs. A white abdominal hernia forms in children, which can be located above or below the navel.

Intervertebral

A hernial bulge of this location is rarely observed at birth. It develops in children due to physical overload, after spinal injuries, or due to abnormalities in its structure. In this case, the cartilage located between the vertebral bodies is squeezed out. More often, such a hernia is localized in the lumbosacral region.

Why is a hernia dangerous?

Any hernia is dangerous due to the possibility of strangulation. As a rule, this leads to the development of peritonitis. Only emergency surgery can save a child's life.

Why is an umbilical hernia dangerous in children? Cases of strangulation of the hernial bulge of this localization are rare, but dynamic monitoring and consultation with a specialist are required if the baby’s condition worsens. If self-healing does not occur and parents reject surgical intervention, a large hernia may form in adulthood, especially in women after childbirth.

Large hernial protrusions are often strangulated, which leads to emergency surgery.

The danger of a hernia in the groin area, in addition to strangulation, lies in the pressure on the pelvic organs. Subsequently, the processes of spermatogenesis in boys and gestation in girls are disrupted. A herniated disc can cause compression of the nerve roots, which is accompanied by severe pain and limits movement. Sometimes there is difficulty urinating and defecating.

Symptoms

Signs of an umbilical hernia in children are more often observed from the neonatal period, while inguinal hernia can develop later. Upon examination, a swelling is detected under the skin around the navel or in the groin area.

This formation becomes obvious with an increase in intra-abdominal pressure of any etiology (crying, sneezing, coughing, straining during bowel movements, when the baby is in an upright position). Gentle palpation helps determine the size of the hernial formation.

By gently pressing your finger on the protrusion, it can be reduced. In the lying position and when the child calms down, the hernia disappears. With small hernias that are easily reduced, the child usually does not experience pain, but is characterized by increased excitability, weather dependence, a tendency to increased gas formation and unstable stool.

Causes

Abdominal hernia in children often begins to form even before birth.

This phenomenon occurs in the following pathological conditions:

• abnormal course of intrauterine development;
• intrauterine hypotrophy;

The following provoking factors play an important role in the formation of a hernia:

• weakness of the abdominal muscles;
• thinning and excessive elasticity of the peritoneum in some areas;
• hereditary predisposition;
• heavy weight of the baby;
• surgery or abdominal trauma;
• high intra-abdominal pressure (flatulence and stool disorders with a tendency to, frequent crying, child’s cough).

An umbilical hernial bulge in a one-year-old child may be the result of an overly expanded umbilical ring and severe muscle hypotonia. This is especially common if the child begins to walk and stand early. In this case, there is usually a defect or absence of a section of the peritoneum in the umbilical area, non-closure of the umbilical ring and the umbilical vein located in its upper part is noted.

Inguinal hernial bulge is more common in male infants. Among the reasons for its formation, a large role is played by hereditary predisposition, weakness of the peritoneal fascia, and prematurity.

How to understand that a child has a hernia?

A hernia in a child’s abdomen is in any case accompanied by the appearance of a protrusion in the navel, groin or along the midline of the abdomen, especially when crying and straining. The size of the formation can vary from a pea to a large plum. Touching the area of ​​the protrusion is sometimes painful, but if it is small, it can be reduced.

Strangulated hernia

It is an absolute indication for surgical intervention. Moreover, within several hours, the bulge in the groin or abdominal wall cannot be reduced, which was previously easily done by the parents. Attempts to do this cause pain and increase the child’s anxiety.

Such phenomena indicate that the formation is compressed in the hernial canal. There is a threat of developing peritonitis due to necrosis of the strangulated intestinal loop. Therefore, a strangulated hernia is an emergency.

Danger signs are:

• Significant increase in size of the hernial formation.
• Redness and increased temperature of the skin over the hernial sac.
• A sharp deterioration in the child’s condition (fever, stool retention, severe anxiety).

If the parents' attempts to correct the situation are unsuccessful within several hours, the child's condition is still poor, it is necessary to call an ambulance. Under no circumstances should you use painkillers or antipyretics, as this can lead to serious complications.

What to do?

Hernia of the white line of the abdomen in children, as well as hernial bulges of the abdomen of other localization, are an indication for the need to strengthen the abdominal wall. To do this, the baby must often be placed on the tummy before feeding; therapeutic exercises and a tonic massage are needed.

Parents should monitor the size and condition of the hernial bulge when bathing and swaddling the baby. At the slightest deterioration of the condition, urgent medical consultation is needed.

Removal of an inguinal hernia in a child can be performed routinely or for emergency reasons. If the hernial bulge is small, parents usually successfully correct it themselves; this does not cause concern to the child. In this case, the operation is planned after the baby reaches one year of age.

If the hernia often protrudes, its consistency gradually becomes thicker, touching it becomes painful, and reduction is difficult, this is an indication for urgent medical consultation. With such dynamics of the disease, surgery should be performed at any age. Suspicion of infringement is a direct indication for emergency surgery.

An umbilical hernia rarely leads to health-threatening complications. Usually, as the child grows older, the size of the protrusion decreases, self-healing occurs, as the tone and strength of the muscles of the anterior abdominal wall increases.

Sometimes, to speed up this process, mothers practice tightly swaddling the baby's tummy or try to strengthen the abdominal wall with a bandage. These activities can lead to compression of internal organs and inflammation of the skin, so you should first consult a doctor. If sealing is necessary, only a hypoallergenic adhesive plaster can be used.

Article publication date: 06/30/2015

Article updated date: 11/08/2018

An umbilical hernia in children is a protrusion of internal organs under the skin of a round or oval shape in the baby’s navel area. The disease occurs in every fifth child.

Children with this pathology are more restless than healthy babies, because common infant problems (colic, bloating) due to a hernia cause them more suffering.

In itself, protrusion of organs does not pose a threat and may not even bother the baby. The danger of an umbilical hernia is that fragments of the peritoneum, omentum, and intestinal loops can get inside this protrusion and become strangulated. Fortunately, this does not happen very often, but the possibility of such a development does exist.

During the first year of a child's life, spontaneous disappearance of an umbilical hernia is possible. As the child grows and develops, especially if parents engage in physical exercise and strengthen their strength, the muscles of his abdominal wall become stronger, the umbilical ring becomes denser, and its diameter decreases.

In a less optimistic course of the disease, the size of the protrusion can reach 5 cm in diameter, although it usually does not exceed 1 cm.

An increase in symptoms and a progressive increase in the size of the hernia is an indication for surgical treatment. It is carried out when the child is 2–3 years old.

Many parents are frightened by the very word “operation,” but if the surgeon insists on performing it, it should be done. Surgical intervention techniques are worked out to the smallest detail and are applied taking into account the individual characteristics of the baby in each case.

The very next day after the intervention, the child can get up and eat liquid food, and after a couple of weeks the operation itself will become just a memory. There are no scars or relapses of the disease after surgery. In 95% of cases, the intervention takes place without complications.

Causes and predisposing factors

The immediate cause of an umbilical hernia is anatomical weakness of the tissues in the area of ​​the umbilical fossa.

But in the presence of provoking moments, the disease develops more often. This:

• prematurity;
• low birth weight of the child;
• heredity (the disease more often occurs in children whose parents had an umbilical hernia in childhood);
• conditions that provoke an increase in pressure in the child’s abdominal cavity (excessive crying, constipation, cough, flatulence);
• diseases in which muscle tone decreases (rickets, malnutrition);
• umbilical hernia is more common in girls than in boys;
• sometimes umbilical protrusion appears after the baby begins to walk, especially if this happened early enough (because his muscles are not yet strong enough).

There is an opinion among parents that umbilical hernia in children occurs due to “improper tying of the umbilical cord,” but this statement is unfounded; The umbilical cord staple technique does not widen the umbilical ring in any way.

Symptoms of the disease. How does a child with an umbilical hernia behave?

In young children, an umbilical hernia is usually visible to the naked eye. In fact, the main symptom is a protrusion in the navel area, resembling a ball. With gentle pressure on the hernial protrusion, it is easily reduced into the abdominal cavity. If the expansion of the muscle ring is small, then the baby’s umbilical hernia may be noticeable only with some straining (while crying, laughing or coughing).

Such children are more restless than their peers without pathology. There is no baby who does not suffer from colic due to bloating. But children with an umbilical hernia suffer more from them, and they also react more sharply to changes in weather.

Sometimes babies with a hernia experience vomiting, changes in sensitivity in the area of ​​the hernial sac, changes in its color and density. These may be symptoms of a dangerous complication - a strangulated umbilical hernia - and this is a reason to immediately contact a pediatric surgeon.

Treatment methods

This pathology in children is treated both with and without surgery. Treatment tactics are chosen after a joint consultation of a small patient with a local pediatrician and a pediatric surgeon.

What methods will avoid surgery?

Monitoring a child and treating an umbilical hernia at home

Three methods for treating hernia at home:

1. Gymnastics and tummy massage

10 minutes before feeding, place the baby on his tummy on a hard surface covered with a warm diaper. He begins to actively move his torso, arms and legs, while intra-abdominal pressure decreases due to increased release of gases. The child's anterior abdominal wall will be strengthened by systematically repeating these actions 2-3 times every day.

It is better to start a tummy massage at the age of two months: first, with a massage instructor in a children's clinic, who will teach you the correct procedure technique, and then mom or dad performs this massage on their own.

2. Using a fixing patch

The patch is applied for 10 days so that a fold forms in the navel area. Three courses of such sealing usually lead to the disappearance of the baby’s umbilical hernia.

The patch should be hypoallergenic and not irritate the baby’s delicate skin.

Combining this method with therapeutic exercises and massage gives a more lasting result.

Instructions for use of the Porofix patch. To fix the patch you need:
1) Clean and dry the skin around the navel well.
2) Fix the patch to the left and right of the navel.
3) Insert patch “a” into the eye of patch “b”.
4) Tighten the patch.
5) Fix this position.

3. Traditional methods

Many parents try to practice traditional methods of treatment: applying a copper coin, an oatmeal cake, a piece of gauze moistened with cabbage juice, etc. to the navel area. Reviews of such methods of dealing with an umbilical hernia are most often positive, but it is necessary to take into account a significant nuance : Any object placed on the hernia area requires fixation. And you can securely fix something on an infant only with the help of an adhesive plaster!

Operation

If the diameter of the umbilical ring does not exceed 1.5 cm, then surgical treatment can be avoided in 99% of cases. If parents actively use all the methods of conservative treatment recommended by the doctor, the hernia disappears on its own by 2–3, maximum 5 years.

If the diameter of the umbilical ring is 2 cm or more, surgery cannot be avoided. Children are usually operated on when they reach the age of three. In any case, the operation should be performed before the child goes to school.

There are two types of surgery.

There are two types of hernioplasty:

(if the table is not completely visible, scroll to the right)

Sometimes an urgent operation is performed due to the deterioration of the child’s condition (the baby is crying, he has severe bloating, non-reduction of the hernial sac and a change in its color and density, nausea and vomiting).

This operation takes longer, and the postoperative period is lengthened, since the intervention itself is more complex: it is necessary to eliminate the strangulation, restore blood circulation in the strangulated organ and cut through adhesions (connective tissue seals). And only after these steps they begin to correct the hernial opening. Usually, in this case, implants cannot be used, since simply suturing the hernial orifice will lead to the appearance of new adhesions and pain in the scar area.

Therefore, parents should not neglect the advice of a surgeon. It is better to perform the operation as planned, without creating a health risk for your baby.

Prevention of the development of umbilical hernia in a child

Proper care of the baby and implementation of preventive measures can prevent the occurrence of an umbilical hernia, even if the muscles of the umbilical ring are weak, and there is still a certain risk of a hernia.

Typically, a doctor observing a child gives parents the following advice (mostly related to the nutrition of mother and child):

• Try to maintain breastfeeding for as long as possible: this will prevent constipation, bloating, and intestinal dysbiosis.
• A nursing mother should not eat foods that cause flatulence in the baby: whole milk, legumes, grapes, cabbage, baked goods and other sweets, smoked meats, nuts, carbonated drinks.
• If breast milk is insufficient or absent, it is necessary for the doctor to select a formula for artificial feeding. An umbilical hernia in childhood often develops with congenital lactose intolerance.
• Protect your child from colds, do not let him cry for a long time, because coughing and crying provoke an increase in intra-abdominal pressure, and, therefore, aggravate the symptoms of a hernia.

Owner and responsible for the site and content: Afinogenov Alexey.