Congenital inguinal hernia in girls. How to treat a rare disease for girls - inguinal hernia. What is an inguinal hernia

Inguinal hernia on the right side of a 9-year-old girl

In the photo: an inguinal hernia on the right side of a 9-year-old girl - how it looks before and after treatment

The girl's parents contacted us from Voronezh. In their city, they were denied surgical treatment in a day hospital. The parents sent the surgeon's report and the ultrasound protocol. The day of the operation was set. The child passed the necessary tests, the parents sent copies by e-mail. We arrived at the hospital on the day of the operation. Settled in a single room. The girl was examined by a pediatric surgeon and an anesthesiologist-resuscitator. There were no contraindications for surgical treatment. The child and mother in a change of clothes went to the operating room. Mom held her daughter's hand during the entire time during the induction of anesthesia. The child fell asleep quite calmly, the mother went to rest after a trip to the ward. Further, all planned manipulations were carried out. The operation took 17 minutes. The hernia was not very large, but plastic surgery of the inguinal canal and the external opening of the inguinal canal was required. All surgical procedures were performed to the required extent. A cosmetic suture was applied. As you can see in the photo, the seam is slightly larger than the phalanx of the index finger, which is 15-17 mm. On the operating table, while the patient is under anesthesia and does not feel pain, the operation site is blocked with a long-acting anesthetic. The conscious girl was taken to the ward with her parents. After 1 hour the child began to drink, after 1.5 hours he began to eat and exercise. After 3 hours, the parents and their daughter left the hospital and went home. Further communication with my mother took place via email and Watsapp.

Inguinal hernia in a girl (photo). Laparoscopy

In the photo: an inguinal hernia in a girl on the left. Laparoscopy. Stitches after laparoscopic treatment

At the consultation, the surgeon had a suspicion of an inguinal hernia on both sides. Together with the parents, it was decided to perform laparoscopic hernia treatment. The advantages of laparoscopy are that the surgeon first examines the abdominal cavity with an endoscope (diagnostic laparoscopy) and makes a decision based on objective data (open or closed inguinal canal) to place an instrument for further treatment. The girl was diagnosed with an inguinal hernia on the left, a closed inguinal canal on the right. Left laparoscopic hernioplasty was performed with Prolen 3/0 thread. Cosmetic intradermal sutures were applied. The size of the wounds on the abdominal cavity is not more than 5 mm (in the photo in relation to the instrument - the width of the instrument is 11 mm).

What does an inguinal hernia look like in a girl on the right

In the photo: an inguinal hernia in a girl on the right. Open surgical treatment of inguinal hernia. Cosmetic self-absorbable suture no more than 2 cm, which does not need to be removed.

Bilateral inguinal hernia in a 4-year-old girl

In the photo: bilateral inguinal hernia in a 4-year-old girl

A girl from the Mytishchi region. Diagnosis - bilateral inguinal hernia. When visiting the city hospital in order to receive surgical care, they said that two operations should be performed with a difference of 6 months. At the same time, they refused to operate on two hernias. Parents turned to our center for help in surgical treatment. After a preliminary examination by a surgeon and a pediatric anesthesiologist, we came to the conclusion that we can operate two hernias in one hospitalization. After determining the date of the operation and passing the tests, the child was hospitalized in a single room with his parents. The child and mother in a change of clothes were brought to the operating room. The child became somewhat worried and refused to lie down on the operating table. Therefore, the introductory part of anesthesia was carried out in my mother's arms. As the child fell asleep, he was transferred to the operating table. Mom left the operating room. Necessary anesthetic and surgical manipulations were performed. The girl had contents in one of the hernias: an ovary with a fallopian tube. The contents of the hernia were removed into the abdominal cavity with atraumatic forceps Aesculap Gmbh. The further course of the operation passed without technical difficulties. A non-removable cosmetic suture was applied. Local blockade with a prolonged anesthetic. After 2 hours, the girl began to walk calmly on her own. The parents wanted to leave the hospital. After examination by a surgeon and an anesthesiologist, the child was allowed to go home with recommendations. When performing two operations at the same time, the parents ruled out one hospitalization and one anesthesia, did not take an additional sick leave to care for the child for the second operation for 7 days.

Inguinal hernia on both sides in a 5-year-old girl

In the photo: inguinal hernia on both sides in a 5-year-old girl.

Parents turned to us in a clinic from the city of Volgograd. In the city hospital, the parents were denied a one-stage bilateral operation for the child. With this request, they turned to our medical center. In Volgograd, on our advice, the girl underwent an ultrasound of the pelvic organs to exclude the pathology of the reproductive system. Parents passed tests at the place of residence and arrived at the clinic on the day of the operation. The child was hospitalized in the ward with his parents. 40 minutes after hospitalization, the girl was taken to the operating room. The operation lasted 45 minutes. Cosmetic sutures were applied and local prolonged anesthesia was performed. The child woke up in the ward, not worried. Dad during this time, before the return trip, slept on the next bed. The girl was operated on, her parents had a rest, everyone decided to go back home. The child was discharged after 3 hours with recommendations under the supervision of a surgeon at the place of residence.

Of all types of pediatric surgical disorders, inguinal hernia is diagnosed most often. Congenital hernias are formed even during the prenatal development of the child and, unfortunately, cannot be influenced. The disease can manifest itself at any age, in some children - immediately after birth, in others - after several years. An interesting fact is that inguinal hernia in girls occurs fewer times than in boys.

Hernia - bulging of an internal organ or a small part of it through anatomically weakened areas of connective tissue or holes formed. The organ or part of it is located in the intermuscular space or the resulting "pockets". The external manifestation of a hernia is a subcutaneous bulge resembling a tumor.

Classification

There are two main types of damage

• congenital;
• acquired.

In the first case, the cause of an inguinal hernia in newborns is the weakness of the abdominal muscles, provoked by a failure in the intrauterine development of the baby. If a child was born prematurely, or physiologically immature, his organs simply do not have time to fully form.

In older children, various tumors, lung diseases and excess weight can provoke disorders. An inguinal hernia can appear from excessive stress, heavy loads, when the child strains the abdominal muscles.

Violations of the second type appear due to external factors - operations or injuries. Even a strong attack of coughing, vomiting and crying can provoke the appearance of a hernia.

Prerequisites for development

The appearance of a hernia in girls is different from the problem in boys. When a girl is still developing in her mother's womb, her uterus is located much higher than its usual position. Then she gradually descends. And pulls the peritoneum. Delicate connective tissue covers the abdominal cavity from the inside. As a result, the peritoneum forms a fold that protrudes forward and slips into the inguinal duct, forming a pocket. This is how a hernia occurs. It happens rarely, but the consequences for the health of girls are quite serious, you need to respond immediately.

The main causes of hernia:

• the presence of congenital anatomically vulnerable places and openings on the abdominal wall or in the abdominal cavity (femoral or inguinal canals, esophageal opening in the diaphragm, navel);
• acquired injuries of parts of the abdominal wall (surgery, injuries);
• the presence of diseases that entail an increase in intra-abdominal pressure (tumors, constipation, chronic pulmonary diseases, accompanied by a debilitating cough);
• obesity (most relevant for children under the age of 6 years).

Danger

In girls, a hernia is much less common than in boys, but its manifestations have no less dangerous consequences. The hernial sac creates unwanted pressure on the delicate tissue of the still undeveloped ovaries. Due to the onslaught, it will atrophy and even be able to die. FROM the slightest suspicion of a hernia in a daughter, parents should immediately consult a doctor, conduct an examination and consultation. There is a risk of hernia strangulation. Quite painful sensations and the risk of tissue necrosis. You can not delay treatment.

Recognize a hernia

The main sign of the manifestation of an inguinal hernia in girls is the hernial aneurysm itself. Most often, it is quite noticeable and is located in the groin area. But sometimes the following happens, the hernial bulge descends even lower, into the left or, more often, into the right labia majora, increasing its size. Very rarely, but still there is a bilateral hernia.

The symptoms of the problem are as follows:

• the bulge increases when the child is standing and decreases or disappears completely when the girl lies down and relaxes the abdominal muscles;
• when sneezing, coughing, stressing, it increases in volume;
• rumbling can be seen on palpation.

Occasionally, hernias are also accompanied by the following symptoms: indigestion, pain in the abdomen, constipation or diarrhea.

Treatment

When the doctor diagnoses this disorder in a girl (taking into account all the obvious symptoms), he prescribes a planned surgical operation. Other methods of overcoming the pathology (even in newborns) do not yet exist. If the operation is not carried out in a timely manner, there is a rather high risk of complications. True, there is no need for emergency intervention, unless the hernia is infringed.

The doctor who observes the child in the hospital will set the date when it is necessary to arrive for hospitalization. Until that day, the child and his parents have time to pass all the necessary tests: feces (for helminth eggs), urine and blood. The operation is performed only if the child:

• good analyses,
• no colds,
• there are no other diseases.

Otherwise, surgery should be postponed until the child is completely healthy and his condition is much better. Of course, parents need to understand that the operation cannot be postponed forever and it is not worth delaying it. After all, infringement of a hernia in girls can happen at any time, and then doctors will be forced to perform an operation to save the life of a small patient.

Therefore, it is advisable to do everything ahead of time. If an oblique hernia occurs, the risk of infringement is minimal, so doctors often suggest postponing the operation until the child is 5-6 years old. And so that the situation does not worsen, they prescribe the constant wearing of a special bandage.

Operation

To cure a hernia, it is necessary to return the organs to their place, correct the bulge and remove the hernial formation. You also need to strengthen the abdominal walls to prevent possible complications. Therefore, getting rid of a hernia is possible only through surgical intervention. The operation is quite simple for an experienced surgeon. A hernia is operated on for no longer than 20 minutes. This operation is performed only under general anesthesia.

When anesthesia begins to take effect, the surgeon performs 3 main manipulations:

1. makes a small (1.5–2 cm) incision and gets directly to the hernial bulge;
2. carefully examines the hernial formation and sets the organs in it to their proper place;
3. the bag cuts off and removes, imposes several stitches.

The child is discharged from the surgical hospital usually on the 3rd day after the operation. If the stitches are those that need to be removed, this procedure is done 7-10 days after the operation.

After the child is discharged from the hospital, it is necessary to limit all physical activity in order to avoid a possible relapse. In a word, eliminate any possible causes of recurrent hernial protrusion. All that remains after the operation is a small scar.

Congenital inguinal hernia in girls is rare, and is caused by weakness of the muscular septum or incomplete fusion of the vaginal process during fetal development. Such a disease manifests itself with volumetric swelling in the inguinal region, which is noticeable already at the birth of a girl. The formation of an inguinal hernia in girls is explained by the fact that the uterus, gradually descending, displaces the peritoneum behind it, and a kind of pocket is formed, which becomes the main factor in the appearance of a hernia. This is not the only reason for the formation of a defect, because an inguinal hernia in girls can also appear during the first weeks or months of life, which is associated with a sharp increase in intrauterine pressure during screaming, crying. This occurs more often in premature girls with a genetic predisposition to the disease and weakness of the anterior abdominal wall.

A hernia in the groin area with the exit of the omentum or part of the intestine can be dangerous for a girl only in case of complications and infringement of the organ, then an urgent operation is needed.

If the inguinal hernia in a child does not progress and remains the same size, conservative therapy is carried out, exacerbation is prevented, and if after 5 years it has not been cured, a decision must be made to surgically remove the defect.

Main Risk Factors

The causes of protrusion of organs in children, especially girls, lie in the disruption of the digestive tract:

1. Prolonged constipation due to malnutrition or concomitant diseases of the digestive system;
2. The presence of congenital defects on the anterior abdominal wall, vulnerable areas, which over time are increasingly exposed to negative influences and weaken, skipping the internal organs;
3. Birth trauma, accidental injury to the abdomen, surgery;
4. Lung diseases, tumors that increase intrauterine pressure;
5. Obesity in children, which is common in girls under 6 years of age due to predisposition.

The risk of illness in a girl

For a boy, an inguinal hernia is dangerous by a violation of the spermatic cord and further infertility; in girls, still underdeveloped ovaries are at risk. By the way, read about polycystic ovaries on the site aginekolog.ru The tissue can gradually atrophy and die, this happens extremely rarely, and more often the organ is incarcerated in the hernial sac, which threatens to necrotize it.

How to identify a hernia in children?

A typical sign of the disease in a girl is a swelling in the groin area, it can go down to the large labia, which at the same time increase. It affects mainly one side, but there are also bilateral inguinal hernia in girls.

Specific symptoms of inguinal protrusion in little girls:

1. The swelling increases when the child is raised and decreases when lying down;
2. During coughing, screaming, sneezing, a noticeable push of the hernia and it sticks out;
3. When feeling and pressing on the defect, a gurgling or rumbling sound is heard.

Severe cases of inguinal hernia add symptoms of general malaise, disruption of the gastrointestinal tract, girls experience discomfort in the lower abdomen, and cases of constipation become more frequent.

Treatment of inguinal hernia

Therapy for inguinal protrusion in children depends on the cause and accompanying symptoms. Since surgical treatment before the age of 5 is not desirable, the doctor prescribes physiotherapeutic measures, massage, special gymnastics for aunts, which can be carried out by the parents themselves.

It is important at the first stage of treatment to find out the underlying cause and eliminate it, because any therapy will be ineffective if the muscles are still weak or the child has a constant cough and other factors that affect the disease.

Inguinal hernia in girls is eliminated by the following therapeutic measures:

1. Massage and gymnastics: these methods directly affect the causes of the disease if a hernia occurs after birth. Massage should be done daily to improve blood circulation in the groin and abdominal cavity in order to prevent stagnation and deterioration of the nutrition of the organ located in the hernial sac;
2. Medications are prescribed to treat comorbidities and eliminate the symptomatic complex. These can be painkillers, drugs to normalize digestion;
3. Nutrition is also important for the treatment of protrusion in a girl, it is necessary to exclude overeating and eating foods that slow down the digestive tract, which will be discussed in more detail by the attending physician and nutritionist.

Strangulated inguinal hernia in girls requires immediate surgical treatment. The purpose of such an operation will be to release the organ and return it to its anatomical site, followed by closure of the peritoneal defect that has formed.

The prognosis after surgical treatment is favorable, the hernia is completely eliminated, and if a mesh implant was installed during the operation, the risk of recurrence of the hernia already in the adult period is significantly reduced.

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

Inguinal hernia in boys is more common than in girls. Shortly before birth, the testicles travel a long and difficult path down to the pelvic area. During this period, minor deviations in their movement may occur, which subsequently turn into serious functional defects. The genitals of girls also change their location - just not so radically. Therefore, a hernia is also observed in them, only less often.

Causes in boys

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

When complete infection does not occur, the boy develops unilateral or bilateral dropsy of the testicles or scrotal hernia. It depends on the size of the "hole" and its location. If it is small, clear fluid from the abdominal cavity (dropsy) simply begins to accumulate in the scrotum. If it is large, intestinal loops fall into it (hernia).

Causes in girls

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

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

• bowel loops;
• ovary.

And pregnancy, while maintaining such a defect already in adulthood, will probably end with the prolapse of the entire uterus.

Risk factors

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

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

Unlike an inguinal hernia in boys, in girls, such a defect has no chance of self-eliminating after a few months or years. He does not lend himself to reduction, in any case, permanent. Therefore, if in the case of boys, pediatricians often advise parents to wait until the child is one and a half years old (by this age, the defect may heal itself), then an inguinal hernia in girls requires immediate treatment.

signs

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

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

In addition, if a loop of intestines is prolapsed in a child, during this period he may experience:

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

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

Differences from a tumor

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

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

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

Complications

In case of pinching of the loops of the intestine or ovary falling into the hernial sac, the case may end in their necrosis. Acute infringement of any organs is the most formidable of the complications of a hernia, requiring urgent surgical intervention.

In children, it manifests itself:

• cramping abdominal pain- because of them, the child is restless, crying and screaming;
• rise in temperature- especially with the increase of edema and necrotic processes in the tissues in the strangulated area;
• nausea and repeated vomiting- only if the intestines have been infringed.

Surgery

Treatment is reduced to excision of the hernial sac and stitching its edges surgically. The operation can be postponed until the child reaches the age of one and a half years, but:

• only in boys (possible independent tissue fusion);
• if she is not prone to sharp infringements;
• if it is not accompanied by other defects of the abdominal wall (an inguinal hernia is often accompanied by an umbilical hernia).

Laparoscopic surgery

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

With it, the surgeon "from the inside" excises the edges of the abdominal wall defect and sews it up without making large incisions on the anterior surface of the abdomen. The operation site is accessed through several small (about a centimeter long) incisions. A set of tubes of the appropriate diameter is inserted into them, and with their help they are brought to the site of intervention:

• lighting device;
• video camera with a wide view and high resolution;
• instruments for hernia repair;
• duct.

A special gas mixture is fed into the abdominal cavity through an air duct (to straighten the abdominal cavity and give the surgeon an overview and a place for manipulations).

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

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

Laparoscopy is preferable to classical methods of hernia repair. At the same time, the technique for removing the hernia itself is standard, and the element of novelty is only in the way of accessing it.

Alternative Medicine Methods

It must be understood that in the case of an inguinal hernia, we are talking about the presence of a hole where it should not be - about a “hole” in tissues that should by nature be solid. Such defects are not amenable to the action of medicinal plants, suggestion, conspiracies.

In addition, over time, the edges of the hernial opening, also called hernial orifices, grow into hard cartilaginous tissue. This is their natural response to constant injury from protruding organs. Therefore, the surgeon is forced to first cut the edges to a "living" tissue, and only then - to sew.

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

The use of alternative methods threatens the child only with acute infringement. This phenomenon is unpredictable, and it has only two options for the outcome - an immediate operation or a fatal outcome over the next few days due to necrosis of the strangulated area of ​​​​the organ. If the girl's ovaries were infringed, death may occur earlier - due to severe intra-abdominal bleeding.

Prevention

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

• properly organized physical development;
• avoidance of injury.

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

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A hernia forms when a piece of an organ or tissue in the body (such as a loop of intestine) protrudes through a hole or weakened area in the muscle wall, protruding into a space where it shouldn't be. This protrusion is a hernia, which looks like a cord or lump.

Some anatomical structures that function in utero and overgrow after birth do not have time to close. And babies are born with various small holes inside the body. Nearby tissues can penetrate into such structures, forming hernias.

Unlike hernias that occur in adults, these areas are not always considered a weak spot in the muscle wall. This is a normal, healthy part of the body, which has not yet gone through all the stages of its extrauterine development.

Sometimes tissues can be compressed in the anatomical openings of the muscle wall, which are intended only for the passage of arteries or nerve trunks there. In other cases, stress or injury weakens or thins a specific area in the muscle wall. And if any organ or part of it is in this place, then the pressure created by it can also form a hernial protrusion.

An inguinal hernia is an abnormal bulge that can be seen and felt in the groin area, the area between the abdomen and thighs. An inguinal hernia in children appears when part of the intestine, along with its contents, rushes through the thickness of the abdominal wall muscle.

Between 12-14 weeks of fetal development, the testicles form in the abdominal cavity near the kidneys. As the baby develops in utero, they gradually move down into the lower abdomen. Even before birth, the testicles push through a hole in the tissues between the abdomen and groin and descend into the scrotum.

A similar process occurs in girls - the ovaries descend into the pelvis. After that, the hole in the abdominal wall is closed. This eliminates any connection between the abdomen and the scrotum or groin.

If this canal does not close completely, and the muscles in the abdominal wall do not close the opening well enough, a hernia can develop.

Inguinal hernia in children occurs at any age, but the maximum incidence is observed in infancy and up to 5 years from 80 - 90% in boys.

About 3 - 5% of healthy, full-fledged babies can be born with an inguinal hernia, and a third of infant and child hernias appear in the first six months. In prematurely born children, the frequency of inguinal hernia increases significantly, up to 30%. In more than 10% of cases, other family members also had a hernia at birth or in infancy.

Right lateral hernias are more common than left ones.

Inguinal-scrotal hernia occurs only in boys, while the testicle is compressed, which leads to infertility in men in the future. Inguinal-scrotal hernia in children is divided into testicular and cord.

A hernia in an infant or older child will look like a bulge or swelling in the groin area. Sometimes an inguinal hernia in newborn boys can manifest itself as swelling in the scrotum.

In many cases, swelling can only be observed during crying or coughing. Because of this, parents often assume that crying is caused by a hernia, while most often this ailment in crumbs occurs due to crying for a completely different reason.

Girls are much less likely to develop an inguinal hernia, but sometimes it happens. In this case, the ovaries or a loop of intestines push the abdominal wall into the groin area, and sometimes all the way to her labia majora.

The protrusion will feel like a solid oblong cord.

Generalized swelling in the labia immediately after birth is more likely caused by excess fluid in the newborn or an additional dose of hormones that were received shortly before birth from the mother. This swelling is harmless and goes away after a few days.

What can be confused with a hernia?

Other conditions that may look like inguinal hernias but are not.

1. A communicating is similar to a hernia, except that it forms a bulge in the scrotum with fluid rather than protruding tissue. In some cases, the size of the scrotum changes depending on how much fluid goes in and out.
2. Sometimes a retractile testicle (which occasionally rises up the canal from the scrotum) causes a bulge in the groin area. It may not need treatment, but the condition should be evaluated by a specialist.
3. A femoral hernia is rare in children and may be confused with an inguinal hernia. The hernia is manifested by a bulge in the upper thigh, just below the groin.

Complication of an untreated hernia

An inguinal hernia in children tends to get stuck, meaning the lump doesn't go away when the child relaxes. This is called infringement.

Infringement happens quite often.

Symptoms may include the following manifestations:

• the child looks sick;
• pain in the groin;
• nausea and vomiting;
• enlarged belly;
• swelling that appears red and is visibly tender to the touch;
• swelling that does not change in size when crying.

If the tissue gets stuck, the full blood supply will eventually not be provided. Without a good blood supply, the organ can die. It may be life threatening.

If you think your baby has an inguinal hernia, see your doctor. Diagnosis is carried out by careful study of the medical history and close medical examination. If the hernia is not visible during the visit, the doctor will try to identify it by gently pressing on the child's abdomen.

No additional tests are usually required to diagnose a hernia.

Treatment

Inguinal hernias require surgery, and to avoid the risk of pinching the abdominal organs, surgery is performed as soon as possible.

If there is an inguinal hernia, treatment without surgery will be ineffective. Surgical removal of a hernia is the only effective method.

Contraindications for hernia repair:

• the body is severely depleted;
• there are associated serious conditions.

The size and type of bandage is selected strictly individually, depending on the location of the hernia. The bandage is not able to eliminate the hernia. It only prevents the infringement of the hernia and prevents the organs from completely falling out into the resulting sac.

An operation to remove an inguinal hernia in children is necessary in all cases, even if the hernia is not yet pinched. The child should not eat for 6 hours before surgery to reduce the risk of vomiting and aspiration (breathing in liquids or vomit) during anesthesia.

1. An anesthetist (a doctor who specializes in pain relief) gives the child a general anesthetic, which relaxes the child's muscles and induces sleep. The child will not feel pain during the operation.
2. A small incision (2 to 3 cm) is made in the skin fold of the groin.
3. The hernial sac containing the small intestine is determined.
4. The surgeon pushes the bowel inside the hernial sac back into the abdominal cavity, into the correct position behind the muscle wall.
5. The empty hernial sac is removed.
6. The muscle wall is secured with sutures to prevent another hernia.
7. If the child is younger than 1 year old, the chances that the hernia will develop on the other side of the groin are very high. Therefore, correction of the inguinal region is recommended. If there is currently no hernia on the other side of the groin area, the muscle wall is reinforced with stitches.

For inguinal hernia in children, surgery is usually very simple. However, babies can be difficult. In boys, the muscular opening is very close to the vessels and cords that are connected to the testicle.

A hernia can damage these blood vessels, especially if it gets pinched before surgery, but the surgeon must also be careful to protect the vessels.

• there is a small risk of injury to the testicular blood vessel. This leads to poor growth, or even testicular loss;
• infection of the wound may occur, causing redness and pus discharge a few days after the operation. In this case, antibiotics will be required;
• bruises at the site of hernia repair are quite noticeable, but by themselves they rarely cause swelling. The swelling usually goes away after a few days;
• rarely the hernia returns, and then there is a need for a second operation. This can even happen a day or two after surgery.

Most children will be able to go home a few hours after the operation. However, premature babies and children with certain medical conditions will have to spend one night in the hospital for observation.

Child care after surgery

Usually in the evening after the operation and the next morning the child feels well. There is no set time when the baby can return to normal activities. An older child should focus on their comfort and pain. However, it is recommended not to exercise for several weeks.

You can wipe your child with a sponge dipped in water the next day after the operation. Bathing in the bath is allowed 2 days after surgery.

If there is any redness or discharge from the wound, seek medical attention. You can give your child as directed every six hours for 24 to 48 hours.

Forecast

The prognosis is favorable. If an inguinal hernia is removed surgically in children, it is unlikely that it will recur. The recurrence of a hernia occurs somewhat more frequently if there is any damage to the bowel.