Hernia of the linea alba in a 2-year-old child. What you need to know if a child is diagnosed with a hernia of the white line of the abdomen. Symptoms of divergence of tendon fibers

Newborns are often diagnosed with hernias located in the white line of the abdomen. If they are not properly treated, babies can have serious problems in the future.

At the beginning, a tubercle appears in children, small in size, in the region of the white line of the abdomen, which after a while can increase significantly in size (there are situations in which such a hernia reaches a diameter of 5-10 cm).

If the hernia does not bother the baby, his parents still should not be careless and consult a specialist. Delay can lead to infringement of the hernia and emergency surgery.

The reasons

When conducting numerous studies, experts have identified the main cause of the hernia of the white line of the abdomen in infants.

This disease develops against the background of weak development of connective tissues located in the area of the white line of the abdomen. In patients, this tissue becomes thinner very quickly, and as a result, holes appear in the aponeurosis.

The reasons for the development of a hernia include a congenital anomaly in the development of the white line of the abdomen (in some newborns, too wide gaps between the fibers of the line are found).

The disease can also progress in the category of young patients who have physiological underdevelopment of the aponeurosis.

Weakening of the connective tissue in the region of the white line of the abdomen can occur in the following cases:

with any injury to the abdominal cavity;
with the growth of adipose tissue;
with poor heredity;
with a sharp increase in intra-abdominal pressure;
for problems with bowel movements
with prolonged crying;
with infantile cry, etc.

Symptoms

In most cases, a hernia of the white line of the abdomen in newborns is accompanied by the following symptoms:

swelling appears at the site of the hernia;
swelling with any tension of the abdominal cavity can change its size;
after eating, the baby begins to behave restlessly;
pain sensations appear (the baby may experience pain in the lumbar region, in the region of the shoulder blades, in the hypochondrium);
nausea and vomiting;
belching, especially after eating;
heartburn;
stool retention;
the appearance of blood clots in the stool, etc.

signs

With a protrusion of a hernia of the white line of the abdomen, in newborns, the bulges can be located in different places. They are classified as follows:

sub-umbilical hernia (located under the umbilical ring);
supra-umbilical hernia (the location of this bulge is above the navel of the child);
paraumbilical hernia (located in the region of the umbilical region).

At the initial stage of development, this type of hernia is quite problematic to diagnose, since parents of newborns pay attention to the disease only when a protrusion appears.

With the progression of the disease, elements of adjacent organs can penetrate into the area of the hernia sac: omentum, small intestine. In some young patients, doctors discover several hernias in the area of the white line of the abdomen at once. With multiple localization, hernias can be located one on top of the other.

Hernia of the white line of the abdomen has several stages of development:

To date, medicine knows a large number of cases when a hernia of the white line of the abdomen stopped its further development even at the first stage.

Diagnostics

Parents of newborns who have independently identified a hernia of the white line of the abdomen in their babies should immediately consult a doctor. The specialist will prescribe a number of measures that will confirm the preliminary diagnosis and prescribe the correct treatment.

Doctors (depending on the situation) may prescribe:

radiography of the abdominal cavity;
ultrasound procedure;
multislice computed tomography of the abdominal organs;
herniography;
esophagogastroduodenoscopy.

Treatment

In the case when a small hernia of the white line of the abdomen is detected in newborns, the surgeon sets it with his hands, and then tightly fixes it in this position with a patch. Massage and physiotherapy exercises are also prescribed for newborns as a therapy for small hernias.

If the hernia does not disappear during long-term therapy, doctors perform surgical treatment of this disease. During surgery, a part of the omentum is cut out by the surgeon.

To do this, carefully open the contents of the hernia. In most cases, during surgery, surgeons remove the diastasis of the rectus muscles, which are located in the abdominal cavity (near the hernia).

When conducting emergency surgical treatment, doctors can use various methods:

tension hernioplasty. With this technique, local tissues of the abdominal cavity are involved;
non-stretch hernioplasty. With this surgical method, mesh prostheses are involved.

With timely surgical treatment, patients almost never experience relapses.

In order to avoid any complications after surgery, parents of newborns need to monitor their nutrition and prevent constipation, in which the abdominal muscles will become very tense.

Complications

With strong muscle tension (for example, with constipation) of the abdominal cavity in patients diagnosed with a hernia of the white line of the abdomen, various complications may occur:

infringement of the contents of the hernia;
intestinal obstruction, accompanied by severe pain
the appearance of blood clots during bowel movements;
the development of inflammatory processes in the hernia and adjacent organs;
as a result of strong pressure on nearby organs, they may be injured, etc.

The cost of surgical treatment

Each medical center that specializes in the surgical treatment of hernias of the white line of the abdomen in infants sets its own prices for these operations. The pricing policy for surgical treatment of hernias directly depends on the size of the bulge, its location and stage of development.

Prevention

To prevent the appearance of a hernia of the white line of the abdomen in a small child, his parents need to take preventive measures. The child must be taught to physical activity from a very early age, but this should be done gradually.

It is important not to miss preventive examinations at local pediatricians, on which the doctor will immediately identify any deviations from the norm during palpation. Many experts recommend tempering children, and this should be done almost from the first days of their lives.

In order to prevent a hernia of the white line of the abdomen in newborns, pregnant women are advised to wear special bandages. Compliance with the regime, maintaining a healthy lifestyle and long walks in the fresh air will positively affect the health of the developing fetus.

In order to prevent the development of a hernia in an infant, his parents should ensure that he does not cry for a long time, since during cries he will greatly strain the abdominal cavity.

It is also important for mothers, especially breastfeeding children, to carefully monitor their diet. Many foods that enter the baby's body with breast milk can cause constipation, which provokes the appearance of hernias of the white line of the abdomen.

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A hernia of the white line of the abdomen is more often diagnosed in adults aged 25-40 years and in children as a birth defect. It is formed on a vertical surface from the xiphoid process to the pubic joint. The white line is 10 to 25 cm wide at the navel and narrows to 5 mm. It is in the area of the divergence of the tendon plate at the level of the navel that a hernia of the white line of the abdomen appears in a child. The defect can be paraumbilical, supraumbilical and subumbilical.

A hernia of the white line develops quite rarely, and even less often it can transform into an umbilical protrusion.

Tendon fibers during protrusion of internal organs can diverge by more than 10 cm, because an advanced disease is dangerous and requires surgical treatment.

Development mechanism and causes

With a hernia of the white line in children, bulging of such organs as the omentum, intestinal loop, stomach through pathologically enlarged tendons occurs. The process is localized in the navel, but umbilical hernia is not observed. The more the child has expansion of the fibers, the higher the risk of infringement.

Such a disease can occur in newborns already in the first days or months of life, which is associated with a genetic predisposition and congenital weakness of the musculoskeletal system. Due to such deviations, the muscle ligament expands and the organs of the abdominal cavity near the navel protrude. Rare causes of the disease in newborns are birth trauma and prolonged crying.

Clinical manifestations

A hernia of the white line of the abdomen in a child may be present imperceptibly for several months and even years, if there are no other ailments and physical activity. But this is a rare exception, and in most cases this disease develops acutely with pronounced manifestations. First, in children, a bulge in the abdomen of a small size is visually determined, which can already be observed in newborns. This protrusion is round, when pressed, it penetrates back into the abdominal cavity.

Gradually join the following symptoms in newborns:

In children with a hernia of the white line, constant tearfulness is noted, which is associated with unpleasant and painful sensations in the navel;
There is bloating, diarrhea or constipation;
The long course of the disease leads to infringement and necrosis of the organ.

Incarcerated hernia in a newborn is extremely rare, but is a life-threatening condition.

The child must be operated on immediately to remove the affected tissues, which die and lead to intoxication.

Types and diagnostics

Depending on the location of the hernia in newborns and older children, the following types of disease are distinguished:

Supraumbilical or epigastric: localized above the navel and occurs in 90% of cases;
Paraumbilical or paraumbilical: localized in the umbilical region, but unlike the umbilical protrusion, it is extremely rare - in 1% of children;
Subumbilical or hypogastric: located below the navel.

A hernia of the white line of the abdomen is complicated when intrauterine pressure rises sharply or inflammatory, infectious diseases of the abdominal cavity are present.

A strangulated hernia is extremely dangerous for a newborn, despite the fact that it is rare.

The child has symptoms of intoxication, dyspepsia, vomiting, severe pain, from which the children constantly cry. In the process of pinching, the abdominal organ (omentum or intestines) is compressed in the hernial sac, blood circulation is disturbed, which quickly leads to dysfunction and necrotic processes. This can result in organ rupture and peritonitis.

How is a hernia detected?

When the doctor sees a bulge in the abdomen, the examination begins;
Palpation is necessary to determine mobility and consistency;
When pressing, the doctor evaluates the sensations of the child, his reaction;
Newborns are examined at rest and tension;
If difficulties arise, children are sent for ultrasound, gastroduodenoscopy.

Before starting treatment for a hernia, a child's blood, urine and feces are taken, and the blood is also examined for hepatitis, syphilis and HIV.

How to treat?

Removal of hernias of the white line is exclusively surgical, but when it comes to newborns, the operation is postponed and the child is monitored. Observation is accompanied by conservative methods of protrusion treatment: massage, physiotherapy, medicines.

When is the operation performed?

Up to two years, the disease progresses, the defect increases in size;
Up to five years could not be cured without surgery;
At any age there is an infringement or other complication.

Children undergo open tension-free hernioplasty or laparoscopic surgery. Elective surgery without complications is more often performed by laparoscopy, but when there is a risk of damage to internal organs, open access treatment is indicated so that it is possible to examine the abdominal cavity.

The operation is performed under general (safe for the child) anesthesia. The defect is often sutured with artificial material, since the muscle ligament in a child is weak, but according to indications, hernioplasty using natural tissues is possible.

Mesh closure gives a better prognosis, as there is little to no risk of recurrence. The fabric grows through the mesh easily and the load on the seams is distributed evenly.

In the case of suturing with own tissues, there is a risk of suture divergence and recurrence of the disease.

The duration of the operation is from 20 to 60 minutes, and the next day the patient is discharged home. The sutures are removed after a week, the child wears a postoperative bandage for some time, follows a diet and takes general tonic drugs.

Prevention

Preventing the recurrence of the disease is the main goal of the rehabilitation period. Parents should monitor the behavior of the child, exclude prolonged crying, tension. It is important to follow a proper diet to prevent constipation and bloating. Gradually, the child must be accustomed to physical education, do daily abdominal exercises with him, take walks, but exclude high loads and stresses.

There are purely childhood diseases, and there are ailments that are most common in adults. These include a hernia of the white line of the abdomen, but nevertheless, although rare, it still happens in children.

Definition and pathogenesis

In adults, the disease manifests itself between the ages of 20 and 30. On average, for 10 hernias, one is formed at the level of the white line of the abdomen. Unlike inguinal and umbilical, such a hernia in children occurs in less than 1% of cases.

The white line of the abdomen is a vertical muscular strip that begins at the xiphoid process of the sternum and ends at the pubic joint. The middle of this tendon layer passes through the navel and at its level has a width of 10–25 mm, and narrows slightly below to 2–3 mm.

A hernia of the white line of the abdomen in a child occurs when the bundles of the tendon plate diverge at the level of the navel, and loops of the intestine and omentum protrude through them. The wider the divergence of the fibers (up to 10–12 cm), the lower the risk of strangulated hernia. But basically, the hernial ring diverges up to 5-6 cm.

A hernia of the white line of the abdomen in a child may occur against the background of a genetic or acquired anatomical weakness of fibrous fibers . As a result, thinning, expansion, the formation of slit-like holes and the divergence of the rectus abdominis muscles occur. Also, the occurrence of a hernia in may be due to the underdevelopment of a wide tendon plate, consisting of collagen and elastic fibers.

Can provoke a white hernia of the abdomen obesity, abdominal trauma, postoperative scars . As well as an increase in intra-abdominal pressure that occurs with constipation, prolonged crying, chronic bronchitis, whooping cough, etc.

Stages of hernia development

A hernia of the white line of the abdomen has three stages of development. AT first phase a preperitoneal lipoma occurs. Sometimes the disease flows into the so-called initial phase, and sometimes reaches the final stage of formation.

The first phase is characterized by protrusion of preperitoneal cells through a slit-like divergence of tendon fibers. It is this picture that characterizes the formation of preperitoneal lipomas. Very often the disease stops at this stage and does not develop further.

But sometimes a lipoma can transform into a hernial sac filled with part of the omentum and a small area of the small intestine. And the finally formed hernia has a hernial orifice and a hernial sac with contents. Inside the hernial sac, one can often find the transverse colon, loops of the small intestine, and even the walls of the stomach.

Last stage development of a hernia of the white line of the abdomen is perfectly visible to the naked eye. In addition, it is very easy to identify with palpation.

Basically, white line hernias form locally. But sometimes several hernias are formed, located one above the other. Hernias are supra-umbilical, para-umbilical and sub-umbilical.

Signs of a white hernia

A hernia of the white line of the abdomen in a child is not a disease that can lurk for years. Its symptoms are usually visible to the naked eye. And the first sign of a hernia is painful protrusion along the linea alba .

If the child complains of increasing pain after eating, during sports, after defecation, etc., it makes sense to show him to the doctor. If the child feels pain constantly, most likely, he has a temporary infringement of the hernia.

Also, an increase in the pain of a hernia may be due to the tension of the omentum connected to the hernial sac, or an increase in pressure on the nerve endings of the parietal peritoneum. In most cases, a hernia of the white line of the abdomen in a child is accompanied by pain in the hypochondrium, scapula, lower back.

With a strong infringement, the child may feel nausea, a sharp pain in the peritoneum. Also, his condition may worsen due to the retention of feces and gases.

How to Confirm the Diagnosis and Start Treating a Hernia

Any mother should be wary if her child often has a stomach ache. If the pain intensifies, you should immediately consult a surgeon. First of all, he will examine a small patient, and then send him for an additional examination.

In addition to palpation, a hernia of the white line of the abdomen is diagnosed using Ultrasound and computed tomography abdominal organs. In addition, the doctor may prescribe an x-ray of the stomach and duodenum, gastroscopy or herniorrhaphy. The last method of examination is the introduction of a contrast agent into the peritoneum in order to study the hernia.

When confirming the diagnosis, you must immediately set up the child for surgery. Otherwise, a hernia of the white line of the abdomen cannot be cured. In preparation for surgery, you need to exclude certain foods from the diet.

First of all, these are spicy and fatty dishes, including spices. Mom should make sure that the child who was diagnosed with a hernia of the white line does not have butter, semi-finished products, various snacks (for example, chips, crackers), tomatoes, lemons, chocolate on the menu. In addition, it is recommended to exclude vegetables and legumes from the diet, which provoke 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 of brown rice, cereals, vegetables - in particular carrots, cucumbers, asparagus. Fruit, fish, low-fat cheese, egg white, cauliflower, and lean veal may also be given. But we must remember that such a diet is not a treatment, but only unloads the stomach and intestines before surgery.

Operation and recovery

Surgical intervention for a hernia of the white line of the abdomen 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 divergence of the rectus abdominis muscles - diastasis. Only the prevention of further diastasis guarantees a complete cure for a hernia of the white line of the abdomen.

In 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 a recurrence of the hernia, since the load on the sutures is quite large and they can erupt.

Therefore, most often the operation is done using synthetic mesh frame , which covers the aponeurosis and evenly distributes the load on the seams. Since the connective tissue grows through the allomaterial without difficulty, the probability of recurrence is negligible.

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

After surgery comes rehabilitation period , which is accompanied by a special diet and the rejection of physical activity.

Both before and after the operation, you should not give the child spicy, fatty and fried foods. To facilitate the digestion process for the stomach, it is necessary to focus on liquid food: cereals, mashed potatoes, sour-milk products.

In order for the intestines to empty regularly, the child after the operation 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 diet of a small patient. But do not abuse fiber, as its excess can lead to flatulence and colic.

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

How to prevent a hernia

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

Answers

Hernias are currently the most common surgical problem in children. These are defects in the development of the walls of the abdomen, into which the abdominal organs protrude (intestinal loops, bladder) or the fixing apparatus of the intestine - the omentum. A hernia can be caused by many causes and factors contributing to the onset and progression of this pathological condition. In order not to be afraid of this obscure ailment and to be ready to get rid of it, it is recommended to begin by informationally preparing yourself for the fight.

Causes of development and structure

A hernia consists of a hernial sac, hernial contents and a hernial orifice into which the sac with its contents prolapses. The most common cause of hernias is considered to be hereditary predisposition.

information It is important to note that boys suffer from this disease much more often than girls.

Hernia classification

Hernias are classified:

By localization (that is, the place of its occurrence):
- diaphragmatic;
- intervertebral;
- femoral;
- hernia of the white line of the abdomen;
- ventral postoperative hernia.
Size.
The degree of its safety (meaning that sliding, reducible hernias are defects that require planned treatment, and strangulated hernias require immediate surgical correction).

Umbilical hernia

Most often it makes itself felt in the very early period of a child's development - neonatal or in the first months of life, when the umbilical residue falls off and the wound heals. Most often, it is formed due to the anatomical weakness of the umbilical ring, its failure. In addition to the genetic predisposition, the causes of this type of hernia include:

unsuccessful ligation of the umbilical cord;
umbilical vein catheterization for health reasons;
intestinal hyperpneumatosis (excess gas formation);
increased intra-abdominal pressure;
diseases that reduce muscle tone (rickets, malnutrition, asthenia).

An umbilical hernia quite often protrudes when the child is anxious, crying, straining with constipation, but it is easily reduced and very rarely infringed. Clinically, it appears as a round or oval bulge at the umbilicus, with or without separation of the rectus abdominis muscles. It can be of completely different sizes, and they can also increase or decrease. Many parents often perceive such an anatomical feature as a protruding navel as a hernia, but this is not true. But in any case, it is worth consulting with a pediatrician and a pediatric surgeon regarding issues of concern.

information According to the experience of specialists from all countries of the world, it can be confidently stated that in most cases this disease is self-healing. In some children, this happens by 1-2 years, in some it lasts until primary school age.

The elimination of a hernia contributes to:

early laying out of the baby on the tummy, when the abdominal wall is strengthened;
physiotherapy;
gymnastics;
massage.

Surgical correction is indicated in case of infringement or large defects. In a planned manner, operations are usually indicated from the age of five, operations are rarely accompanied by complications or relapses of the disease.

Inguinal hernia

This is also a common type of hernia and is much more common in boys, it almost never occurs in girls.

The causes may also be:

heredity;
features of the anatomy of the groin area;
weakness of the muscles of the abdominal walls;
non-closure of the process of the peritoneum, which forms the inguinal canal.

It is a protrusion in the region of the inguinal canal, in its hernial sac there may also be an omentum, bowel loops, bladder wall, ovary (in girls) or spermatic cord (in boys). This type of hernia is infringed more often than the previous one and requires urgent surgery.

dangerous An inguinal hernia in girls threatens with necrosis (death) of the ovary, so it is extremely important to consult a surgeon if it occurs.

In a planned manner, hernia repair is started when the child reaches 1 year of age or weighs at least 10 kg, when he is ready to adequately endure anesthesia. Modern surgery will provide the baby with a gentle operation, minimal blood loss and a high-quality cosmetic suture. Complications and relapses occur only if the doctor's recommendations are not followed.

Hernia of the white line of the abdomen

The white line of the abdomen is an anatomical formation that is located vertically from the xiphoid process of the sternum to the pubic joint and is a connective tissue formation that connects the rectus abdominis muscles. In its structure there are several jumpers, in the event of a divergence of which a hernia is formed. Most often, they form just above the navel in fairly well-fed children with increased intra-abdominal pressure. The content is a protective layer of adipose tissue in front of the outer sheet of the peritoneum. Infringement of it threatens with tissue necrosis. Treatment is only operational, both in a planned and urgent manner.

Diaphragmatic hernia

This is the most formidable type of hernia. It is rare, most often in combination with multiple malformations. The mortality rate for this type of hernia is high.

information Diaphragmatic hernia occurs when the membrane between the thoracic and abdominal cavities fails, as a result of which the abdominal organs are displaced into the chest and squeeze the lungs, causing them to collapse and increase pressure in the pulmonary artery, displacement and compression of the heart.

Usually the disease is diagnosed on the first days of a child's life and is operated on urgently. The recovery period after the successful completion of the operation is usually long, requires long-term drug therapy, mechanical ventilation, parenteral nutrition (nutrient solutions in the form of intravenous infusions).

Symptoms

Symptoms of infringement of any of the hernias (except diaphragmatic) are:

Soreness in the protrusion, aggravated by pressure.
Increased body temperature, feeling chills, weakness.
Change in skin color over the affected area from bright pink to purplish-bluish.
The inability to reduce the hernia back into the abdominal cavity.
Feelings of tingling or fullness in the hernia.

important In this case, it is urgent to seek help from a doctor. The sooner the child receives medical care, the less likely complications are. Self-medication, folk methods are a stupid waste of precious time.

Features of the postoperative period and consequences

After the operation of hernia repair and plastic surgery, relapses are possible if you do not follow the strict recommendations of the doctor, so the child needs to create the most comfortable conditions for recovery and rehabilitation. It is important to adhere to a diet, limit physical activity that can cause an increase in intra-abdominal pressure, engage in physical therapy with the baby during the recovery period, and take a course of general strengthening massage. Caring for the baby, patience, love and understanding will help solve the problem of hernia recurrence and make the childhood of a small person happy and joyful.

Hernia in newborns and infants is a pathology that requires close attention from parents and doctors. About what hernias are in such small children, and how to treat them, we will tell in more detail in this article.

How does a hernia form?

Any hernia is an anomaly in which the internal organs "peep" outward, leaving the place assigned to them by physiology. Organs or their parts pass through a hole, gap, which are normal or defective, and the integrity of the skin or other membranes is not violated. A protrusion is possible in the space between the muscles, if it was formed under the influence of certain factors, under the skin (with an external hernia) or into the internal cavities (with an internal hernia).

This formation appears when the balance provided by nature between the internal pressure and the resistance of the shell is violated. The structure of any hernia is approximately the same, it includes a hernial sac (stretched membrane), a hernial orifice - an opening through which the exit occurred and hernial contents (what is inside the sac).

The danger of a hernia lies not even in the fact that it has appeared and is taking place, but in the fact that at any moment under the influence of certain factors or without obvious reasons, it can be infringed. This condition occurs when the hernial orifice is narrow, and the contents of the sac tend to change in volume (for example, an intestinal loop as the contents of an umbilical or inguinal hernia can be filled with feces).

The consequences of such a condition are always negative - this is necrosis of a clamped organ or a certain part of it, a threatening condition for the patient's life. In an infant who cannot yet complain of certain symptoms, it can sometimes be quite difficult to identify a hernia. It all depends on the attentiveness of the parents and their awareness of where hernias appear and how they look.

Types of hernias in infants

All hernias are divided into congenital and acquired. . According to the nature of the course of the pathology, diseases associated with such formations are divided into complicated and uncomplicated. In addition, the international classification provides for the division into primary and recurrent hernias. There are also postoperative hernias.

According to the ability to mobility, these formations can be reduced and not reduced. Approximately a quarter of all diagnoses are internal formations, more than 75% are assigned to external ones. Among children of the first year of life, the following types of hernias are most common:

Diaphragmatic hernia

With such a pathology, part of the internal organs, which should be located in the abdominal cavity, rise up into the chest.

The reasons. Diaphragmatic hernias in children of the first year of life are always congenital. The reasons why such a hernia forms in a child at some point in fetal development have not been fully investigated by scientists, but doctors are inclined to believe that it is due to insufficient elasticity of the connective tissue, impaired metabolism in the expectant mother, as well as a genetic “failure” .

Symptoms. Symptoms are manifested by severe difficulty in breathing in a child, a special shape of the abdomen in the form of a boat. They are immediately noticed by doctors in the hospital. In rare cases, the disease is opened only after a day or two. The modern level of diagnostics allows you to see such a hernia even on ultrasound during pregnancy.

Treatment. Treatment is always only surgical, and now there is even an opportunity to carry out a correction even before the birth of a child. But such an intervention is associated with rather high risks for the fetus and its mother, and therefore the operation is sometimes postponed until the postpartum period. The baby is sent for emergency surgery immediately from the delivery room. It takes place in two stages - first, the crumbs make a “patch” on the hole in the diaphragm from their own piece of skin. And after a while this patch is removed. If the hernia is not bilateral, then the forecasts are quite optimistic: in 80% of cases, doctors manage to save the life and health of the child. In the case of bilateral hernias of the diaphragm, a fatal outcome is most likely.

Hernia of the white line of the abdomen in a child

These formations, passing through the center of the abdomen perpendicular to the womb, can be small and quite large - up to 10 centimeters in diameter. The exit of the internal organs occurs between the weak muscular lines of the midline.

The reasons. Such hernias can also be acquired, but they always are based on congenital pathologies of the connective tissue, which can disperse, forming rather large “pockets” due to screaming, coughing, constipation, when the baby strains the peritoneum. The weakness of the connective tissue is due to some adverse intrauterine factors, such as malnutrition, oxygen, metabolic disorders, as well as genetic disorders.

Symptoms. Such a hernia is unstable in size, and this is its main distinguishing feature. With any movement of the abdominal muscles, it will visually either decrease or increase. After eating, the child behaves more restlessly than before eating, he is tormented by belching, constipation. In its development, a hernia of the white line goes through several stages: first, a gap appears, which will soon become a hernial ring, after a while, you can notice the protrusion of the hernial sac. In the supine position, the hernia becomes more noticeable. And only when the bag is fully formed, symptoms appear.

Treatment. A small hernia does not always need treatment, there are many cases in medicine when it goes through a stage of independent reverse development as the child grows. But this process cannot be left to chance. Doctors such simple hernias are manually reduced through the skin, after which the place of bulging is fixed with an adhesive plaster. The child is given a massage. If conservative treatment fails, the hernia grows in size and there is a very real risk of pinching it, a decision is usually made to operate, since today this is the only alternative. Surgeons adjust it and sutured the pathological hole or fix it with a mesh implant.

Inguinal hernia

This type of childhood hernial disease always has a congenital factor. During fetal development, the testicles in boys form in the abdomen, and therefore descend through the inguinal canal down. If by the time of birth the “tail” from the peritoneum lowered along with the testicles does not grow over, and the inguinal canal continues to communicate directly with the abdominal cavity, a hernia in the groin may develop.

In girls, such pathologies occur several times less often, and they are associated with a similar non-closure of the "pocket" (vaginal process), which is formed when the formed uterus descends at the 5th month of the mother's pregnancy, from above into the pelvic area.

The reasons. The condition of the abdominal muscles of the child affects the likelihood of developing an inguinal hernia. In some, it appears at birth, and in some it is found only after a few months. Her protrusion is promoted by a strong cry, constipation, bloating.

Symptoms. Usually, an uninjured inguinal hernia does not cause any trouble to the child. It doesn't hurt, it doesn't itch. At rest and sleep, it becomes visually indistinguishable. In boys, education often appears on the testicles. A scrotal hernia can be either unilateral or bilateral. But in girls, the hernial sac usually protrudes from both sides, while looking for it should be on the labia.

Treatment. An inguinal hernia does not disappear on its own, as sometimes a median white line or umbilical hernia does. Surgery is always needed to cure. During surgery, the doctor completely excised the hernial sac, preserving its contents as much as possible. This measure is determined by the state of the organs that were included in it. If there was no infringement, there was no necrosis, then the doctor sets the organs to their proper places and sutures the hole, which has become the entrance gate for the internal organs.

If necessary, plastic restoration of the damaged or enlarged inguinal canal is also done, it is brought to normal size in order to prevent secondary prolapse of the abdominal organs. Operations are performed by both abdominal and laparoscopic methods.

Pediatric surgeon Alexander Ivanovich Sumin will tell you about the dangers of an inguinal hernia in the next video.

Umbilical hernia

This is the most common hernia in newborns and children under one year old. It is not directly related to congenital pathologies of development, except that, having tried, you can find several reasons for the weakness of the connective tissue, which, however, are characteristic of all hernia diseases. However, such a hernia is not a mandatory companion of gross defects in the development of the fetus.

The umbilical cord, which becomes unnecessary with birth, is cut off. The umbilical ring remains. In the baby, it should be overgrown with the very connective tissue with which many babies have such problems. This process usually ends by the end of the neonatal period. If the process is slowed down or does not go at all, then a hernial sac is formed from a weak peritoneum, in which intestinal loops, part of the omentum and other internal organs protrude out through the umbilical ring.

The reasons. The appearance of a hernia provokes a strong load on the abdominal muscles. If a child cries for a long time and strongly, coughs, suffers from severe periodic constipation and bloating, his chances of getting an umbilical hernia are very high. In premature babies, the incidence of pathology is higher than in full-term babies.

Sometimes a hernia does not appear in the first months of life, but closer to a year. In this case, doctors consider as one of the reasons the early setting of the baby on the legs or hanging in jumpers and moving in a walker. Until the peritoneum is ready for the perception of vertical load, the child must crawl - this is a more natural way for him to move. The reason for the appearance of a hernia can also be in the navel tied incorrectly or poorly in the maternity hospital, as well as in the infection introduced at the same time.

Symptoms. It is not difficult to determine an umbilical hernia in a child - a swelling appears in the area of \u200b\u200bthe umbilical ring, which has a bluish color if the intestinal loops are clamped, or reddish if the omentum or part of the liver enters the hernial sac. The hernia looks like a small (1-5 cm in diameter) rounded nodule with smooth or irregular edges. It protrudes from the child when he cries, strains during bowel movements or coughs. In a calm state lying on the back, this nodule is invisible. With a slight pressure on the knot with your finger, it is easily set back. You can examine a month-old child on your own at home, it is desirable to control the condition of the navel very carefully, at least up to a year.

Treatment. In the vast majority of babies, an umbilical hernia disappears without a trace by itself as the abdominal muscles grow and strengthen. Often, pediatric surgeons set it, fix it with a band-aid, and show parents how to change this band-aid from time to time. Additionally, a massage is prescribed, which is designed to strengthen the press. They try not to prescribe surgical treatment up to 5 years without urgent need. Such a need arises only when infringement occurs, but this, fortunately, is quite rare.

When carrying out planned operations for children after 6 years old, standard hernia repair schemes are used. Today, children undergo both conventional and laser surgeries. After removing the hernial sac, the surgeon can perform an umbilical plasty so that the child grows and does not hesitate to expose the stomach (this is especially true for girls).

You can also listen to helpful tips from a professional doctor in the video below.

brain herniation

Most often we are talking about a spinal hernia, which is considered the rarest and most difficult in the treatment of pathologies of this kind. It is usually registered in newborns and infants with impaired functions of the musculoskeletal system. Almost always, congenital cerebral hernia leads to disability. The hernia is congenital, but not inherited. This is a sign of violations in the formation and development of the fetus during pregnancy.