Removal of a hernia of the white line of the abdomen in a child. Hernia of the white line of the abdomen. Stages of hernia development

A hernia of the white line of the abdomen in a child is quite rare. If such a hernia appears in children, then after 5 years. The condition is very painful, because in a short period of time, the baby, in the appeared tendon gap, begins to accumulate fat and protrude internal organs.

Definition

The white line of the abdomen is an arrangement of elastic vertical muscles that stretches from the chest to the pelvis of the child. At the level of the navel is the middle of the tendons, their width is 2-3 cm and narrows closer to the pubic joint. A hernia occurs in children when the tendon ligaments diverge in the center, forming a gap. Through this gap, the internal organs that are located in this area begin to protrude. Bowel loops and sebaceous glands begin to protrude. Usually the lumen is about 6-7 cm. If the divergence of the fibers is increased, then the hernia will develop with small pressures in the abdominal cavity.

Development of the disease

The most common cause of a hernia of the white line of the abdomen in children is a genetic predisposition and, acquired over time, anatomical weakness of muscle fibers. For this reason, there is a constant expansion of fibrous fibers and their thinning. When the muscles strongly diverge in one place, slot-like holes appear there.

Provoke the disease in young children can be trauma to the abdomen, excessive eating and obesity. If the child had to undergo surgery in the abdomen, then the remaining scars on the body can also lead to the development of a hernia. Postoperative scars do not pose a threat, but they create an opportunity for other negative factors.

There are other reasons for the development of the disease. You can find in children a weak development of a wide tendon plate in the abdominal cavity, it consists of elastic collagen fibers. As a result of their constant deformation, a hernia of the white line occurs.

A hernia can appear with frequent and prolonged crying, high pressure in the abdominal cavity, with chronic bronchitis, whooping cough. The disease, during which children often have to cough, with its symptom, puts a constant strain on the muscles and tendons of the abdomen.

In young children, these muscles are not yet strong and are very elastic, so regular exposure to them leads to deformation.

signs

A hernia of the white line of the abdomen at the first stage passes without specific signs. Such health problems begin to develop slowly and symptoms are not felt.

Children may feel a slight protrusion of the skin in the abdominal region and not attach importance to this. If children are not worried about pain, then they may not complain about a strange formation.

The protrusion may not be noticed at the first sign of a hernia. The protrusion of the muscles of the white line of the abdomen occurs with the load and tension of the abdominal press. The protrusion disappears if the child is lying on his back or is in a relaxed state. A hernia of the white line of the abdomen can have two varieties. Reducible hernia changes with muscle tension, may decrease when the child is in a horizontal position. Irreducible almost does not change, it can grow with time, but not decrease. Unlike a reducible hernia, an irreducible one, with strong pressure on the protrusion, does not disappear in the abdominal cavity, it does not change in size and retains its shape.

After a while, the protrusion becomes painful and gradually increases. The sensation of pain during a hernia is often concentrated in the stomach. In a more acute form of the disease, pain extends to the lower back, ribs, and the inner region of the abdominal cavity. The pain can be pulling, cutting, creating periodic injections at the site of the protrusion of the internal organs and aching, which will bother the child throughout the day.

The feeling of pain in children always increases after eating or drinking. Any tension in the abdominal muscles and tendons leads to increased pressure and pain in the abdomen. Physical exertion, sneezing, coughing, and defecation can increase blood pressure.

After reducing the pressure on the abdominal muscles and abdominal walls, the pain gradually decreases. With a still sleep, it may be completely absent.
Dr. Komarovsky, a pediatrician, notes that in addition to pain, a baby with a hernia also has other signs of the disease - dyspeptic. Muscle contraction can lead to nausea and vomiting, the baby develops digestive system dysfunction, which is accompanied by frequent heartburn, belching and bad breath.

With an increase in the protruding sac with an internal organ, children may develop a stomach and duodenal ulcer, with complications, gastritis, pancreatitis, and cholecystitis occur.

When the protruding formation is pressed into the abdominal cavity, the child develops acute pain, which becomes more intense. Signs of a severe stage of a white line hernia can be very severe. Children are accompanied by constant vomiting, bloating and aching pain, defecation and involuntary release of gases, painful peristalsis occurs.

In such a situation, conventional methods of treatment will not help. The patient needs an operation to remove the resulting bag in order to prevent serious damage to the internal organs. The operation in practice is carried out quite often if the signs of infringement of the hernia intensify.

Diagnosis and treatment

Examination of the patient for the presence of a hernia of the white line of the abdomen is carried out in the hospital.
First of all, it is necessary to interview the patient and find out what worries him. If the baby cannot independently explain his well-being, then the parents should indicate the place for which the child most often clings and rubs. This is the collection of anamnestic data.

The doctor conducts a general examination of the patient, examines the skin protrusion in a vertical position and in a horizontal position. After an external examination, an ultrasound of the abdominal cavity, gastroscopy, an x-ray of the abdomen and an analysis of the image are prescribed.

Even an external examination by a qualified doctor will allow you to establish a characteristic protrusion of the white line. The doctor may ask the child to rise from a lying position. At such a moment, the abdominal muscles tighten and the hernia protrudes.
In the case when the signs are not visually observed, the doctor will feel the entire area of ​​the white line of the abdomen from top to bottom. One of the first signs of the disease is the divergence of the abdominal muscles. A stethoscope will help you hear a characteristic rumbling in this area. If it is absent, then it is not a hernia.

There are other methods for diagnosing the disease. To establish a diagnosis and prescribe treatment, the doctor may also prescribe a urine and blood test of the child, an X-ray of the stomach, and an MRI of a protruding hernia. Differential diagnosis is carried out in case of pancreatitis, cholecystitis, stomach ulcer, metastases of the swollen omentum.

Treatment should be carried out after the final diagnosis. For each form of the disease, its own method of treatment is selected. The best way is to perform an operation to remove the hernia. Timely operation and removal of a hernia can eliminate a possible complication and its development into a more severe form.
If a hernia was noticed at the very beginning of its appearance, then a special massage is prescribed for treatment, the use of a bandage for constant wear.
Usually in young children, the protrusion of the white line of the abdomen cannot go away on its own, even with active attempts to eliminate the signs of the disease. Surgery is the only effective way to remove the protrusion in the abdominal cavity and stop the development of the disease.

Surgical intervention

Surgical removal of a hernia of the white line of the abdomen is also called hernioplasty. The operation is always carried out under anesthesia of the patient. The operation has 2 types: tension and non-tension.

The mild form is operated on using the child's own tissues to remove the protrusion and close the gap in the abdominal muscles. The hernia is removed with catgut sutures. After surgical treatment, the child should be excluded from increased physical activity, as this can lead to divergence of the sutures and recurrence of the disease.

Another method is carried out using an endoprosthesis. Such an operation is performed to remove a more serious hernia. This method is the most efficient. The advantage of endoprostheses is characterized by reliability and elasticity of tissues. At the same time, children are not limited in mobility and physical activity.

There are some contraindications for surgery - severe illness, infection, and a protrusion that does not retract into the abdominal cavity. With such contraindications, the child needs to stop the increase in the protrusion. For this, doctors prescribe a bandage that must be worn constantly.

Complications and prevention

With a complication, the disease of the white line of the abdomen can turn into a paraumbilical hernia. This is considered a pathology of the disease. Paraumbilical hernia is characterized by a strong protrusion of the internal organs in the abdominal cavity and reaches the umbilical ring. Usually this form of hernia is congenital or caused by chronic diseases of the intestines, digestive and respiratory systems. The most severe complication is the uncontrollability of the hernia.

As a preventive measure, it is necessary to ensure that the baby does not overeat and regularly empties the intestines. At the age of 5, the child must gradually begin to engage in physical education.

Video "White abdominal hernia in children"

In the issue, Dr. Okulov talks about the features of a white hernia in children and describes the methods for the most effective fight against the disease.

Depending on what can cause the disease, where and how it manifests itself, pathological formations on the abdomen can have various forms, classified according to:

• origin (congenital or acquired);
• localization (external and internal);
• clinical course (complicated, uncomplicated, recurrent).

Most often in children, there are congenital external uncomplicated hernias of the abdomen caused by anatomical abnormalities in the area of ​​the peritoneal wall. They are characterized by the presence of "thin areas", weakness of connective tissues. These types of hernias include:

• inguinal;
• umbilical;
• epigastric (in the upper part of the white line of the abdomen).

Experts identify a number of predisposing causes, the presence of which can cause an illness in children. The main ones are:

• genetic predisposition;
• defects in the walls of the peritoneum of a congenital nature;
• underdevelopment of tendons, injuries.

The disease is provoked by high pressure inside the abdominal cavity, the occurrence of which is facilitated by the following producing factors:

• chronic bronchitis accompanied by severe cough;
• constipation and bloating;
• problems with urination;
• overweight, sudden weight loss;
• hoarse prolonged crying (this applies mainly to infants).

Symptoms

The main symptom and the first signs indicating any type of hernia is the occurrence of a protrusion at its location. Its dimensions can be completely different (from a few millimeters to tens of centimeters in diameter). Various other symptoms are evidence of the presence of one of the following types of hernia:

• reducible,
• uncomplicated unguided,
• disadvantaged.

If, when the child is lying on his back or lightly pressing on the formation, it decreases or disappears completely, is not accompanied by pain, we can talk about a reduced hernia. When, in the absence of pain, it is not possible to hide it in the stomach, this indicates an uncomplicated unreduced pathology. The presence of these types of hernia can sometimes be manifested by the following symptoms:

• aching pain;
• problems in the digestive system (constipation or disorders, nausea and vomiting);
• disorders in the urinary system.

These are in themselves signals to visit a doctor. But the most dangerous is a strangulated hernia, the symptoms of which are:

• sudden severe pain in the area of ​​​​its localization;
• fever and severe vomiting;
• a previously reduced protrusion turns into an unreduced one, becomes painful and tense.

Diagnosis of abdominal hernia in a child

The occurrence of the above symptoms can only allow a person far from medicine to assume the presence of one or another type of hernia. After all, a number of diseases have similar symptoms. Diagnosis is the prerogative of the doctor.

After examining the patient and analyzing the history of the child’s life (what he was sick with, what operations he underwent) and complaints (time of onset of symptoms, their intensity, causes of their occurrence), he prescribes the following types of examinations:

• ultrasound of organs located in the peritoneum;
• Ultrasound of the protrusion itself;
• x-ray herniography;
• computed tomography;
• radiography of the gastrointestinal tract.

Based on the results obtained, the doctor makes a diagnosis and decides whether to perform the operation immediately or you can wait a bit.

Complications

The most serious complication of the disease, which is the result of untimely treatment to a medical institution in the event of formidable symptoms, is necrosis when part or all of the organ in the hernial sac is infringed. Abdominal hernia is also dangerous:

• occurrence of intestinal obstruction,
• development of peritonitis
• suppuration.

Treatment

Only an umbilical hernia can be subject to a conservative type of treatment, and even then if the child's age has not exceeded three years. This is due to the fact that the pathology can disappear by itself. It consists in:

• applying an adhesive bandage equipped with a rigid pad;
• conducting a massage;
• doing special physical exercises that help strengthen the abdominal muscles;
• a special diet to prevent bloating or constipation.

Planned surgery is postponed for some time also in the presence of the following factors:

• inflammatory skin diseases,
• exacerbation of chronic diseases,
• SARS and other colds.

Any other type of abdominal hernia is subject only to surgical treatment. An absolute indication for an emergency operation is a strangulated hernia.

What can you do

Parents must:

• be attentive to the complaints of the child;
• take adequate measures in case of detection of symptoms that are indicators of a hernia in a baby;
• follow the prescriptions and recommendations of the doctor;
• provide the child with conditions that exclude the possibility of complications.

What does a doctor do

The doctor must:

• conduct a thorough examination of a small patient,
• make an analysis of the anamnesis of the course of the disease and the life of the child,
• confirm the preliminary diagnosis by prescribing all the necessary studies,
• prescribe appropriate treatment.

Prevention

It is impossible to prevent the occurrence of abdominal hernia, but it is possible to minimize the factors that provoke the occurrence of both the pathology itself and its complications. Preventive measures include:

• organization of proper nutrition for children of any age;
• instilling a love for sports in a child;
• the right choice of the type of sports activities aimed at strengthening the abdominal muscles.

Articles on the topic

In the article you will read everything about the methods of treating such a disease as a hernia of the abdomen in children. Specify what effective first aid should be. How to treat: choose drugs or folk methods?

You will also learn how untimely treatment of abdominal hernia in children can be dangerous, and why it is so important to avoid the consequences. All about how to prevent abdominal hernia in children and prevent complications.

And caring parents will find full information about the symptoms of abdominal hernia in children on the pages of the service. How do the signs of the disease in children at 1.2 and 3 years old differ from the manifestations of the disease in children at 4, 5, 6 and 7 years old? What is the best way to treat abdominal hernia in children?

Take care of the health of your loved ones and be in good shape!

A hernia of the white line of the abdomen is a disease uncharacteristic for children. It occurs in 0.7-0.8% of all hernias. In a child, this disease is detected later than the age of 5 years, in case of unsatisfactory development of the aponeurosis. The consequence of this condition is the appearance of gaps in the tendon bridges. Pinching occurs in the rarest of cases.

Causes and forms of pathology

The white line is a tendon strip, it is located between the pubic fusion and the xiphoid process. In the upper part of the abdomen, it is expanded, in the lower it is narrowed. Accordingly, more often the divergence of the tendons occurs in the upper part. Diastasis - the divergence of tendon fibers - can be up to 10 cm, there is a high risk of transition to an umbilical hernia.

Hernial orifice can have a different shape:

• oval;
• round;
• diamond-shaped.

Infringements of a hernia often occur with tight gates. Sometimes several hernial protrusions are diagnosed, located one above the other.

The cause of the disease can be:

• hereditary pathogenesis;
• acquired anatomical weakness of fibrous fibers;
• underdevelopment of the tendon plate caused by intrauterine anomalies.

Stages of the disease

The abdominal muscles diverge and become thinner, holes are formed among the tendon fibers. With the pathology of the tendon plate, there is a lack of collagen production.

The origin of the hernia is affected by the unnecessary weight of the child and abdominal trauma. With cries or prolonged tension, intra-abdominal pressure increases, which also provokes a divergence of muscle fibers. A long increase in intra-abdominal pressure appears with whooping cough and bronchitis - during debilitating cough attacks, with continuous constipation.

You can systematize the severity of the disease in 3 stages.

At the third stage, the protrusion becomes visible visually, and is easily palpated by palpation. In rare cases, there are several hernias located one above the other. In this case, supra-umbilical, umbilical and sub-umbilical hernia are diagnosed at the same time.

Symptoms of divergence of tendon fibers

After the diagnosis is established, the treatment of a hernia of the white line of the abdomen in children begins. A characteristic sign of the condition is a protrusion in the form of a small bump on the surface of the peritoneum closer to the epigastric region. At the same time, additional symptoms appear - heartburn, nausea - which intensifies with steep movements, say, inclinations.

The disease in the first stage may not manifest itself and be detected during a medical examination by a doctor.

However, even the asymptomatic course of the disease is accompanied by the claims of the child and some signs. The kid often complains of pain in the abdomen, he has diarrhea or constipation after physical effort. During bowel movements, constipation causes pain in the epigastrium.

Complications of a hernia - infringement of the hernial sac.

Signs of the condition - acute pain at the site of the hernia, high fever, vomiting, bloating. Touching the stomach responds with pain, which intensifies during movement.

Diagnosis of the disease

You need to turn to official medicine for pain in the abdomen of any disposition. This advice is extremely relevant in the case of young children, because. they have a weighting of the condition comes hefty rapidly.

A hernia is diagnosed by palpation, during an ultrasound examination, computed tomography on the abdominal organs.

Additional research may be required:

• radiography of the digestive organs - the stomach and duodenum;
• gastroscopy;
• study of the patency of intestinal loops with the help of a contrast agent - herniorrhaphy.

Often, parents begin to look for traditional healers who offer to treat and reduce the hernia manually, believing that then the operation will not be required.

But even special medical bandages do not help prevent the subsequent aggravation of the condition. It is unthinkable to wear them continuously, and there is no guarantee that colic in the intestines will not occur at the moment when the bandage is removed. An increase in intra-abdominal pressure will immediately provoke the subsequent bulging of intestinal loops.

The only way to get rid of the disease is to remove the protrusion during surgery. If this is not done in a timely manner, then the child may develop intestinal obstruction or the organs in the hernial sac will grow together with its walls.

Operation of a hernia of the white line of the abdomen in children

Before surgery, you need to conduct appropriate preparation. The child is transferred to a special diet - all dishes that stimulate increased intestinal motility are completely excluded from it. The diet is also changing - now the baby is fed in small portions in 2-3 hours, no more.

You will have to give up your favorite treats for children: chips, crackers, sugary carbonated drinks, convenience foods, chocolate, citrus fruits. Food should be prepared without spices, increase the amount of fiber in the diet due to cereals - oatmeal and buckwheat.

It is recommended to introduce chestnut rice, asparagus, carrots and fresh cucumbers, cauliflower into the diet. Meat and fish are only low-fat, yolks are removed from eggs, lactic acid products are selected with a low content of fat.

Removal of a hernia of the white line of the abdomen in a child is carried out under general anesthesia. The operation is called hernioplasty.

With the third degree of severity, more often than not, suturing is carried out with support using unnatural materials - synthetic prostheses.

The hernial sac is opened during the operation, its contents are removed and put in place - if possible - or sutured, but the main goal of the surgical intervention is to eliminate diastasis. If this is not done, the disease recurs.

On the basis of one's own tissue, suturing is carried out quite rarely - in this case, the lack of aponeurosis is sutured with a special non-absorbable suture material. But there is a risk of re-bulging of the problem area with an increase in intra-abdominal pressure - the sutures can erupt.

In order not to expose the child to a threat - a second operation - a mesh frame is installed. The design evenly distributes the load on the seams and closes the diastasis. In the future, the connective tissue sprouts and the risk of recurrence is minimized. The operation is considered simple, it is allowed to get up on your feet more closely the next day. But you should not take the baby home - it is desirable that the patient be under the supervision of a doctor for 48 hours, no less.

The rehabilitation process requires adherence to a diet - it is not much different from the diet,
the one that was needed during the preoperative preparation. Portions are gradually increasing, the time between meals is lengthening. Dishes that irritate the intestines are excluded from the diet, but the emphasis should be on liquid food or jelly-like dishes.

It is necessary to carefully monitor bowel movements, include laxative foods in the diet. The number of fruits should be limited - excess fiber can lead to flatulence.

Physical activity increases little by little. The rehabilitation period can take from 2 months to six months.

Preventive actions

To reduce the risk of the onset of the disease in infants, from a very early age, it is necessary to monitor the regularity of bowel movements, to prevent hysterical roaring.

Older children should be introduced to sports to strengthen the abdominal muscles - this helps to tighten the aponeurosis.

But even if a child has been diagnosed with a disease, you should not panic. Parents should immediately agree to the operation in order to prevent the formation of complications. The operation to eliminate the hernia is considered ordinary, and for the baby it is less dangerous than the permissible pinching.

Health to your children!

During embryogenesis, at various stages of fetal development, some elements, layers of tissues of the white line of the abdomen, are not correctly and completely formed. These defects include aplasia of the anterior abdominal wall, hernias of various localization (inguinal, umbilical, embryonic, diaphragmatic). A hernia of the white line of the abdomen occurs mainly in adult children (more often in children 5-7 years old). Rarely infringed, does not show a tendency to self-closing.

The reasons

There are many factors that contribute to the emergence and even progression of this pathological condition. Hereditary tendency leads to the occurrence of hernias, it, in fact, is the most common cause of all ailments. The white line of the abdomen, which goes from the xiphoid process to the pubis, is the line of intersection of the aponeuroses of the rectus abdominis muscles. This is where hernias can form.

There are factors that increase intra-abdominal pressure, and circumstances that weaken the anterior abdominal wall. The latter include weight loss, abdominal trauma, abdominal surgery, and diseases that debilitate children.

Factors that increase pressure in the abdominal cavity:

• Postoperative scars on the tummy;
• hereditary tendency;
• Obesity;
• Persistent constipation;
• Prolonged hacking cough or screaming;
• Physical overexertion;
• Ascites.

Prolonged exposure to causes on a small body of a child leads to a weakening of the aponeurosis and muscles of the abdominal wall.

The mechanism of hernia formation

The occurrence of a hernia is associated with the unfinished development of the aponeurosis, in which slit-like defects remain. These flaws exist for the passage of nerves through them, blood vessels that connect the preperitoneal fatty tissue with the subcutaneous tissue. A typical and characteristic place for the occurrence of a pathological condition called a hernia is the upper region of the white line, paraumbilical (paraumbilical) and hypogastric localization is very rare.

During an increase in intra-abdominal pressure, the pre-abdominal fatty tissue falls out, which is subsequently called the pre-peritoneal lipoma. When squeezing this lipoma, acute pain occurs.

This pain syndrome can be confused with similar symptoms in conditions such as inflammation of the pancreas, gallbladder, peptic ulcer, peritonitis, or other abdominal pathologies. Later, the peritoneum falls out and a hernial sac is formed, into which the internal organs exit. This moment is the formation of a true hernia. Accordingly, there are three stages in the development of a hernia of the white line of the abdomen:

• preperitoneal lipoma;
• initial stage;
• formed hernia.

O.P. Krymov distinguishes types of hernia of the white line of the abdomen, depending on its location:

• supra-umbilical (hernia epigastrica);
• subumbilical (hernia paraumbilicalis);
• paraumbilical (hernia hypogastrica).

The latter species is very rare, because this is facilitated by the anatomical features of the white line itself, which narrows and thickens below the navel, so defects are less likely to form here. A child very rarely can develop not one, but several hernias of the white line of the abdomen. In this case, the pathology is called multiple hernias.

If the hernia is large, most often its contents will be the omentum, loops of the small intestine, sometimes the wall of the transverse colon.

Symptoms

Most often, the course of a hernia is asymptomatic, and its parents or doctors find it during a preventive examination.

In the midline there will be a noticeable rounded protrusion, smooth and elastic to the touch, which increases during sneezing, coughing, lifting weights, if you press on it, it can decrease. Also, the protrusion can decrease in the supine position. As for the pain, it is mainly localized in the upper abdomen and increases with pressure, straining and after eating. Parents should also be wary of digestive disorders. These include complaints of nausea, vomiting, heartburn, constipation.

Research methods

• examination and history taking of a small patient;
• auscultation (listening), palpation (feeling) of the hernia;
• general analysis of blood and urine;
• Ultrasound of the contents of the hernial sac;
• gastroscopy;
• X-ray examination of the abdominal organs;
• herniography;
• CT or MRI in difficult situations.

Ultrasound of the white line of the abdomen is considered a very safe and informative research method. It is used to clarify the nature, location of the hernial defect, clarify the contents of the hernial sac.

Abdominal palpation procedure to detect a hernia of the linea alba

Differential diagnosis should be carried out with such diseases:

• Peptic ulcer of the stomach / duodenum;
• Gastritis;
• Appendicitis;
• Cholecystitis;
• pancreatitis;
• Tumor metastases in the omentum.

This requires detailed instrumental and laboratory diagnostics of the digestive system.

Possible Complications

• Infringement of a hernia. The problem in this case is a violation of blood circulation in the organs that are in the hernial sac. The result will be gangrene of the intestine. Moreover, the inflammatory process begins to activate, quickly spreading to neighboring organs. And this will already indicate diffuse peritonitis.
• Irreducible hernia. It is characterized by the fact that it is not possible to set the hernial contents. This is explained by the fusion of the organs of the hernial sac with each other.
• Injury to the formation is dangerous by subsequent damage and inflammation of the abdominal organs.

How to cure?

Any mother should contact a surgeon immediately. He will do everything necessary for the further diagnosis and treatment of your child.

Doctor's note: Even with small hernias, it is necessary to be observed by a surgeon, because there is a high risk of infringement of the hernia.

Treatment of a hernia of the white line of the abdomen only by surgery. This operation is called hernioplasty. It is planned and not very complicated. All surgical manipulations are performed only under general anesthesia. Now surgeons use modern and child-safe means so that small patients tolerate operations well.

Doctor's note: Traditional methods of treating hernias in children concern only umbilical hernias in the early stages of the disease. An abdominal bandage does not treat a hernia if it has already appeared.

Operation as a method of treatment of a hernia of the white line of the abdomen

Depending on the stage of the disease, local or artificial material is used. The surgeon must eliminate the diastasis (divergence of the rectus abdominis muscles). If local fabrics are used, the defect is eliminated with a synthetic thread. This method often leads to the reappearance of a hernia, because the load on the seams is quite large. Therefore, during the operation, synthetic mesh frames or prostheses are more often used, which cover the aponeurosis and the load on the sutures becomes uniform. The probability of recurrence with the use of these scaffolds is almost zero.

The procedure lasts an average of 25-40 minutes, it depends on the complexity and volume of the surgical manipulation.

A few hours after the operation, children with their parents have the opportunity to return home. The stitches are removed after a week and a half.

Postoperative period

After the surgical procedure, a restrictive regimen must be observed for three days, and physical activity is limited for 20 days.

You need to follow a diet:

• you can not eat fatty, fried, spicy;
• liquid foods such as cereals, soups, vegetable or chicken broths, mashed potatoes, sour-milk products facilitate the baby's digestion process;
• to restore strength and improve peristalsis, it is necessary to add juices, fruit and vegetable purees to the diet;
• flatulence and colic can occur with excessive fiber intake.

Prevention

Prevention in infants is to prevent constipation. The child should not overeat and overstrain from screaming. Adult children are recommended to go in for sports, this contributes to the compaction of the aponeurosis.

In order to prevent relapses and reduce pressure on the abdominal wall, a bandage can be used.

With a hernia of the white line of the abdomen, timely diagnosis and treatment is considered a very important and necessary moment, otherwise complications are inevitable. Operative intervention will completely get rid of the disease.

Newborns often have hernias, so many parents have already encountered this diagnosis. But not everyone knows what it is and how to get rid of this problem.

Sometimes it happens that the internal organs suddenly find a loophole in the tissues surrounding them. It can be both a physiological hole and acquired as a result of any violations. Through it, the internal organ partially crawls into those places that are completely not intended for this. This phenomenon is called a hernia. One of its most common locations is the white line of the abdomen, which stretches from the xiphoid process of the sternum to the pubis.

In newborns, the main causes of this defect are long loud cry, severe cough and bad stools. When crying and constipation, the abdominal wall is strongly strained, because of which the connective tissue inside it weakens and diverges. The cause of a hernia of the white line of the abdomen in an older child may be any trauma to the abdomen or a lot of excess weight. There is also a genetic predisposition to this disease.

Symptoms

At the initial stage of the development of the disease, it is rather difficult to notice a hernia, especially when it comes to a newborn child. After all, he cannot clearly say or show where he hurts. Therefore, it is worth taking extremely watch out for the following symptoms:

A hernia of the white line of the abdomen in an older child may also be manifested by heartburn, nausea, pain in the lower back, under the ribs, or in the region of the shoulder blades.

Symptoms that cause discomfort usually do not appear immediately, but as the hernia develops. Therefore, even in their absence, any non-standard bulge on the white line of the abdomen should be examined by a doctor as soon as possible.

Stages of development of the disease

The development of a hernia of the white line of the abdomen in a child goes through three stages:

• a small amount of fatty tissue passes through the gap between the tendons, thereby forming a benign tumor;
• then a hernial sac is formed from this tumor, into which internal organs partially exit;
• the hernial sac falls out through the gaps between the tendons along with parts of the internal organs located in it.

Quite often, the development of a hernia stops at the first stage, but you should not count on such luck, nevertheless. When the third stage is reached, there is chance of serious complications.

All complications resulting from the lack of treatment of a hernia are fraught with very serious health problems. Therefore, the best preventive measure in this case is the timely diagnosis of the disease.

Diagnosis and treatment

As soon as the baby has signs of hernia formation, it must be immediately shown to the surgeon. Primary diagnosis is carried out by improvised means: visual inspection, palpation and listening to the abdomen. These actions are usually enough to make a diagnosis, but in some cases, the doctor may use other methods. The child is given a referral for blood and urine tests, then an ultrasound diagnosis, X-ray or MRI is done.

After the diagnosis is made, the physician decision on treatment. In some cases, a hernia is diagnosed at a very early stage, then it can be cured with a course of special massage, as well as wearing a bandage. But most often, the only reliable way to get rid of a hernia is surgery.

There are only a few contraindications for such treatment:

• severe illness;
• infectious diseases;
• hernia uncontrollability.

If there are contraindications for surgery, wearing a bandage or a special patch. But these methods are usually only able to stop the growth of a hernia, and not cure it.

Surgical intervention

The word "operation" often terrifies young parents. But the procedure for removing a hernia is simple. Such a surgical intervention can be dangerous only if the hernia has reached the stage of complications, but even then it cannot be dispensed with. To minimize the possibility of unpleasant consequences, you need to carefully prepare the child for the operation in advance, properly adjusting his diet.

Operation

There are several types of surgery:

1. Open access. To do this, a vertical incision is made over the place where the hernia is located, and all parts of the organs that were in the hernial sac are released. This method is usually used for infringements and large hernias. The operation with open access allows you to almost completely avoid subsequent relapses. But after it there is a big scar, and rehabilitation is quite painful.
2. Laparoscopy. Three very small punctures are made on the abdomen, after which there are no scars. Through these holes, a laparoscope is inserted into the abdominal cavity - a special instrument with optics. This method is mainly used for small and medium hernias. After the operation, rehabilitation is quick and easy, but relapses of the disease are possible.
3. preperitoneal access. The operation is also performed through small incisions in the abdomen. The intervention occurs with the help of a special balloon that exfoliates the peritoneum. Like laparoscopy, preperitoneal access is good for the absence of scars and an easy rehabilitation period. But the operation itself is quite complicated and lengthy, besides, the risk of recurrence is high.

The method of intervention is chosen by the surgeon depending on the stage of the disease and the general condition of the child. Any of these operations is performed under general anesthesia. The purpose of the surgical intervention is to open the hernial sac, remove the parts of the internal organs that are there, set them in place and suture the divergence of the abdominal muscles through which the hernia has formed.

Sewing is done in two ways..

Rehab usually takes two to six months. At this time, you need to carefully monitor the diet of the child. It should be about the same as during preparation for the operation. But at the same time, you need to give more liquid food: soups, mashed potatoes, cereals, yogurts and kefir. Purees can be both fruit and vegetable, you can also give your child juices. But, nevertheless, you should not abuse fruits too much, as they can provoke flatulence.

Also, it is necessary to carefully monitor the regularity of the child's stool. Constipation is unacceptable, since such tension can lead to a relapse. To avoid them, you need to regularly give your child laxative foods.

During the rehabilitation period physical exercise is prohibited. Any load on the press is unacceptable. If we are talking about a baby, then the danger is also a strong long crying or coughing. Older children should avoid constipation and exercise. But after the end of the rehabilitation period, on the contrary, it is recommended to develop the abdominal muscles, since their strengthening will reduce the risk of hernia recurrence.

Alternative Treatments

Many parents in the event of a hernia in a child prefer to turn not to a surgeon, but to alternative medicine, healers, and various folk remedies. Such a decision provokes the development of the disease. Lack of proper treatment allows the hernia to grow, and there is a risk of various complications. You can get rid of it only with the help of a surgeon Otherwise, no one can guarantee the preservation of the health of the child.

Prevention of hernia

Preventing a hernia is much easier than treating it. If we are talking about a baby, then it is necessary to monitor the regularity of bowel movements. Also, do not let the child scream and cry for a long time. Cough should be treated in the initial stages so as not to lead to prolonged severe attacks. Simply put, if you exclude excessive stress on the abdominal muscles, then the risk of a hernia of the white line of the abdomen in an infant will be minimized.

For children five years of age and older, regular exercise is the best prevention. They will strengthen the muscles, thereby preventing a possible divergence.