Many people are amazed to find out that hernias are fairly common in kids. Babies (especially preemies) can even be born with them.
Hernias in kids can be treated (hernia repair is the one of the most common surgical treatments carried out on children), but it is essential to recognize their symptoms so that you can get your child the suitable medical care.
In children, the most typical hernias are inguinal hernias, which happen in the genital region, and umbilical hernias, which are found around the navel. Both of these hernias most often take place in babies.
When part of an organ or tissue in the body (such as a loop of intestine) pushes through an opening or weak point in a muscle wall, it can extend into an area where it does not belong. This protrusion is a hernia, which might look like a bulge or lump.
Some babies are born with various small openings inside the body that will close eventually. Nearby tissues can squeeze into such openings and become hernias. Unlike hernias seen in adults, these areas are not always thought about a weakness in the muscle wall, however a regular area that has not yet closed.
Sometimes tissues can squeeze through muscle wall openings that are only suggested for arteries or other tissues. In other cases, strains or injuries develop a vulnerable point in the muscle wall, and part of a nearby organ can be pushed into the weak point so that it bulges and ends up being a hernia.
Types of Hernias
There are different types of hernias, and each needs different levels of medical care.
In numerous infant and youth hernias, the herniated tissues might extend just during moments of physical pressure or strain. A prominent bulge might only be visible when a child is crying, coughing, or straining, and it might appear to withdraw or disappear at other times. Hernias in this state are called reducible and are not immediately damaging.
Often tissue can end up being trapped in an opening or pouch and do not pull back. These are incarcerated hernias, and are a major issue needing immediate medical attention. For example, a loop of intestine that is caught and squeezed in the groin area might block the passage of food though the digestion tract.
Symptoms of a put behind bars hernia can include pain, vomiting, and irritability. If you touch the bulge it has developed, it may feel difficult.
A doctor can generally release the trapped tissues by gently squeezing the lump and trying to require it back into the body opening. Because incarcerated hernias can be painful, the doctor generally supplies pain medication during this procedure. Surgery is usually needed within a couple of days to prevent development of another incarcerated hernia.
The most severe kind of hernia is a strangulated hernia, in which the normal blood supply is cut off from the caught tissue. Without that blood supply, the strangulated tissue can not get oxygen and will die. Surgery is needed immediately to dislodge the tissue so that oxygen can get to it once again.
The two most common hernias in kids are inguinal hernias in the groin area and umbilical hernias in the belly-button area.
In infants, an inguinal hernia is most often caused by a protrusion of a loop or part of intestinal tract or a fold of membrane from the abdomen– or in women, from an ovary or fallopian tube– through an opening into the groin (the area where the abdominal area satisfies the top of the thigh). The opening is brought on by the existence of a fold of the peritoneal membrane, which produces a sac. Within this sac, the loop of bowel can extend.
The hernia appears as a bulge in the groin area, particularly when the child weeps, coughs, or stands.
Sometimes, in boys, the inguinal hernia extends beyond the groin into the scrotum (the sac that holds the testicles). In ladies, it can extend to among the external labia (the bigger lips of tissue around the vaginal opening). In these cases, an augmentation or swelling can be seen that extends from the groin into the scrotum or labium.
More typical on the right side, inguinal hernias take place much more typically in kids than women and are most common in preemies, baby boys with undescended testicles, and kids with cystic fibrosis. Kids with a household history of hernias are likewise at risk.
Other conditions that may appear like inguinal hernias, but are not:
- A communicating hydrocele is similar to a hernia, except that fluid causes the bulge instead of protruding tissue. Depending upon its location, the hydrocele might be left to disappear in a year or 2 or it might be treated with surgery. In infants, the hydrocele might not need surgery, as lots of go away by the 2nd birthday.
- Some can alter size depending upon how much fluid enters and out, and some may appear bluish since the membrane that causes the hydrocele is blue.
- Sometimes, a retractile testicle (a testicle that withdraws from the scrotum from time to time) causes a bulge in the groin area. It may not require treatment however must be examined by a pediatric expert.
- A femoral hernia is uncommon in kids and can be puzzled with an inguinal hernia. It consists of tissues that have pressed in alongside an artery into the top of the thigh. It looks like a bulge at the top of the thigh, simply listed below the groin.
Some babies are born with a weak point or opening in the abdominal muscles around the belly button (under the skin) through which some abdominal membrane or small intestine protrudes.
The soft bulge this produces is an umbilical hernia. It is most obvious when the baby cries, coughs, or strains. Umbilical hernias are more common in females, those of African heritage, and low birth weight babies. These hernias range in size from less than 1/2 inch (2 centimeters) to more than 2 inches (6 centimeters).
In many instances an umbilical hernia causes no pain. Normally, a doctor can quickly push it back in. An infant’s umbilical hernia (unlike a grownup’s) hardly ever obstructs or strangulates. In truth, a lot of umbilical hernias, even the bigger ones, have the tendency to close up by themselves by age 2. That’s why the doctor generally recommends waiting and viewing this kind of hernia in an infant rather than operating.
Surgery is essential only if the hernia is huge; grows in size after age 1 or 2; fails to recover by age 4 or 5; or the child develops symptoms of obstruction or strangulation, like swelling, bulging, vomiting, fever, and pain. If such symptoms develop, call the doctor immediately.
Symptoms and signs of Hernias
If you believe that your child may have a hernia, call your doctor right away. And ask yourself:
- Is the bulge present when your child is straining, crying, coughing, or standing, but missing when your child is sleeping or resting? This might suggest a reducible hernia.
- Is the bulge present all the time, however without any other symptoms? This might be a hydrocele or something else.
- Has the groin area suddenly begun to swell? Do you observe any staining of the bulging area or a “swollen” abdomen? Is your child irritable, experiencing pain, constipated, or vomiting? These are signs of a jailed hernia, which calls for instant attention. See a doctor right away or take your child to the emergency department.
- Is the area swollen, red, inflamed, and extremely painful? Has your child established a fever? These may be symptoms of a strangulated hernia. Call your doctor then go directly to the health center emergency department.
Treatment for Hernias
Once an inguinal hernia is identified, surgery will be done to avoid it from ending up being put behind bars. During surgery, the herniated tissue is returned into its appropriate space, and the opening or weakness that permitted it to form is closed or repaired.
Surgery to remedy inguinal hernias is performed on kids of all ages, in some cases even on premature babies.
Inguinal hernia surgery in kids is usually performed on an outpatient basis with no overnight remain in the healthcare facility, but some kids, particularly young babies, may be kept in the health center overnight for observation.
The period of recuperation for kids is fairly short. Many can resume regular activities about 7 days after surgery, with the doctor’s approval. Till that time, kids ought to prevent difficult activity such as bike riding and tree climbing. Of course, if you observe any signs of problems after the surgery, such as bleeding, swelling, or fever, call your doctor.