Abdominal hernia in children

Priv.-Doz. Dr. Hans Albert Beiler 76275 Ettlingen
Specialist pediatric surgery for technical articles index
Priv.-Doz. Dr. Hans Albert Beiler [This member is a doctor]

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Abdominal hernias, hernias also called, are innate in children in general and with the abdominal wall fractures in adults usually not comparable. The mechanism is different and has nothing to do with childhood or with an overload of the muscle connective tissue. So be different treatment and prognosis of abdominal hernias in childhood differ significantly from the approach adulthood. Mesh implants made of artificial materials are used in children only when extensive abdominal wall fractures (eg gastroschisis and omphalocele) or congenital diaphragmatic hernia, if it can not be covered with autologous material. Artificial networks grow and not be reluctant implanted foreign material to remain for decades in the body of the child.

As a frequent cause of abdominal hernias in childhood is usually a lack of closure of abdominal wall during pregnancy necessary gaps, such as the navel of physiological or projections of the peritoneum, such as the testicular capsule in boys. Boys are therefore also affected more frequently than girls. In preterm births abdominal hernias also occur more frequently than children born at term. Most abdominal hernias in children initially do not cause acute symptoms. Often, the parents have only a visible bulge in the abdominal wall, the navel or groin area without the child be in pain. The umbilical hernias are generally harmless. Not so the hernia, which can be trapped. The epigastric hernia make more diffuse complaints. Special shapes such as diaphragmatic hernia, gastroschisis Omphalocelen and are usually detected before birth by ultrasound and supplies immediately after birth.

The typical fracture types are:
Hernias
Umbilical hernia
Epigastric hernia

Rare fracture types are:
Diaphragmatic hernia
Omphalocelen
Gastroschisis

The congenital childhood hernias, the processus vaginalis peritonei, a protrusion of the peritoneum into the inguinal canal has not closed spontaneously. As the boys of the testicle through the inguinal canal walk and part of the peritoneum as the shell does with it, boys are affected more frequently than girls, in which only the master tape, a thin connective tissue located in the inguinal canal. The fracture origin has nothing to do with stress. However, hernias get in first with infection with severe cough. Hazard exists only if a hernia clamps. This pushes a piece of intestine into the breach and jammed in the narrow inguinal canal. There is acute pain and there is the risk that the jammed intestine is not properly supplied with blood and dies. Why should children's hernias are surgically repaired promptly after their discovery.

Umbilical hernias are congenital abdominal wall openings through which nourishes the baby during its development in the womb through the umbilical cord vessels and is supplied with oxygen. In general, these abdominal hernias close shortly after birth and the umbilical cord falls off. In some children, this process takes longer. Since umbilical hernias do not squeeze, until the end of the second year of life may be delayed. Has the umbilical hernia is not closed by this time, a spontaneous closure is no longer expected.

Epigastric hernias may already be present at birth or occur during the course of life. There are small openings in the abdominal wall fascia between the rectus abdominis muscles. They are found between the navel and the lower end of the sternum. They can cause diffuse abdominal pain, as bulges through the small abdominal hernias präperitoneales fat.

When the diaphragm breaks there is a gap in the diaphragm muscle that separates the abdominal cavity from the chest cavity. For large abdominal wall fractures, the displaced and the lungs breathing in the newborn disabled.

Omphalocelen are very large abdominal hernias in the navel area with additional prolapse of organs, often the liver in the sac. This is usually the abdominal cavity itself is too small and there are often accompanying malformations.

In gastroschisis, the abdominal wall of the womb has not closed and the intestines are exposed at birth. These children are the ultrasound examinations during pregnancy, usually before birth and known to undergo surgical treatment in specialized clinics, emergency room immediately after birth.

First Treat hernia

A child's hernia is always an indication for surgery dar. A spontaneous recovery is unlikely. Usually, the child's hernias are closed through a small incision in the groin. Abdominal hernias, the operation is in otherwise healthy children aged 6 months-patient basis. Mesh implants as an adult are not required. Recurrences are extremely rare. In addition to the proven standard method, there are some centers that provide the child's hernias and laparoscopy. Which method is suitable for your child, you should discuss with the surgeon the best of your trust.

Second Treatment of umbilical hernia

In principle, the first two years of life are awaited. In approximately 80% of children closes spontaneously during this period of mostly small abdominal hernia. The surgery is recommended for lasting umbilical hernia in girls, as the hernia may later cause problems in pregnancy. In boys, it is more of cosmetic reasons. The surgery is performed through a small semicircular incision in the lower margin of the umbilicus, which is barely visible later. Again, the procedure on an outpatient basis, unless there are serious underlying diseases of the heart and lungs.

Third Epigastric hernia treatment of

In the epigastric hernia can wait until symptoms occur. A spontaneous closure is unlikely, however. The surgery is performed through a small incision. The gap in the muscular layer is exposed, and closed the abdominal wall rupture with a double row of sutures. The surgery is an outpatient setting.

4th Treatment of diaphragmatic hernia, omphalocele and gastroschisis

The supply of abdominal hernias in specialty hospitals performed immediately after birth. The children are usually after a long period in hospital. The prognosis depends largely on the particular malformations. These large abdominal hernias in childhood are at with modern surgical techniques and intensive care follow-up usually well controlled.

Overall, the treatment of abdominal hernias in a large percentage of all operations in childhood. Through the careful and tissue-sparing surgical techniques and modern methods of anesthesia, most interventions in the meantime be done as an outpatient. Children can recover after the surgery in their familiar surroundings much faster and less stressful. The post-operative risks are generally low and well controlled. Most are simply a short-term pain for 2-3 days. Which surgical techniques of abdominal wall openings for your child to come into question whether the interference can be inpatient or outpatient, will give a detailed history and examination of your child in a pediatric surgical specialists.

Author:
Priv.-Doz. Dr. Hans Albert Beiler
Specialist in Pediatric Surgery
On Lindscharren 4-6 76275 Ettlingen