Bilateral inguinal hernia in children. Symptoms of inguinal hernia in children, methods of treatment and surgery to remove it

An inguinal hernia in a child is a congenital pathology in which the abdominal organs protrude beyond the abdominal cavity in the groin area. In boys - most often it is the intestines, in girls - the ovaries, fallopian tubes.

Reasons for the development of inguinal hernia in childhood

During the intrauterine development of the child, the testicles are formed in the abdominal cavity and only then, through the inguinal canal, descend into the scrotum. With a developmental anomaly, this canal may not close completely and the communication between the abdominal cavity and the scrotum will remain, which leads to the appearance of a hernial defect.

It is this fact that explains that these hernias appear in boys much more often than in girls (80% -90% occur in males). In girls, the cause is a defect in the development and formation of the ligamentous apparatus of the uterus.

At full-term pregnancy, in the absence of the above developmental pathologies, the formation of a congenital inguinal hernia is unlikely

The opinion of Dr. Komarovsky

It is worth drawing the attention of parents to the fact that strong crying, frequent constipation, colds, which are accompanied by bouts of severe coughing, lead to an earlier manifestation of the disease, and exacerbate its course. It is also worth noting that even the maximum possible restriction of the child from all the above problems will not save him from CONGENITAL pathology, which will manifest itself sooner or later anyway, and no one in this situation will be to blame - neither the doctor, nor the parents, nor the grandfather with grandmother.

Since each parent is interested in the full life of his child, when diagnosing a hernial defect, the child should not be limited in sports or other leisure activities associated with physical activity, but should contact the doctors for surgical treatment, which should be performed within a maximum of 6 months.

Diagnostics

All children of preschool age must undergo a mandatory examination by a number of specialists, the list of which should include a surgeon. During the examination, the surgeon pays attention to the inguinal region, performs palpation of this area, in boys it is mandatory to examine the scrotum for the presence of 2 testicles. During palpation, in the presence of a hernia, an enlarged inguinal ring or a hernia is palpated directly, which can descend into the scrotum.

The hernial tumor increases with a strong cough, when the child cries or tries to go to the toilet "by and large". Visually, this may look like an asymmetry of the inguinal region or as a swelling. Additional research methods are usually not required, but ultrasound of the groin and scrotum can be used. MRI or CT are used extremely rarely, only in exceptional cases.

Management of inguinal hernia in children

A diagnosed hernia in a child is a 100% indication for surgical treatment in a planned manner. This pathology should be operated on within 6 months after its diagnosis, regardless of the age of the child. All hernial defects of the anterior abdominal wall are treated exclusively by the surgical method, both in children and adults. The use of folk methods, special exercises, wearing hernia bandages, at best, will slow down the increase in the size of the hernial defect, and at worst, lead to infringement and, as a result, emergency hospitalization and surgery.

What will happen if not treated?

In the absence of timely treatment of this pathology, the hernial defect will gradually increase in size, and this can take years (or months, weeks), but the larger the hernial defect, the greater the likelihood of its infringement. A strangulated inguinal hernia requires emergency hospitalization in the surgical department, if the hernia is strangulated and less than an hour has passed, there is a possibility of spontaneous reduction into the abdominal cavity, against the background of conservative therapy, then they are operated on as planned if reduction has not occurred or the doctor has doubts about the viability of the strangulated organ - Only emergency surgery is indicated. It is worth noting that a strangulated inguinal hernia in girls in any case will lead to emergency surgery.

Symptoms of a strangulated hernia

Sharp pain in the groin on the side of the hernial defect.
The hernial tumor becomes dense, the skin over it is hyperemic, otchnennaya.
If before the infringement it was possible to set it into the abdominal cavity, then after it it is fixed in the hernial ring.
Body temperature may rise, nausea, vomiting, and loose stools may appear.

Operation

Surgical treatment is performed under general anesthesia. For an experienced surgeon, this operation does not cause technical difficulties and rarely exceeds 30-40 minutes. In boys, due to anatomical features, and in particular the presence of the spermatic cord intimately associated with the hernial sac, it requires reverent processing of all elements in this area. After this stage, the operation technique for girls and boys does not differ, the hernial sac is excised, bandaged and immersed in the abdominal cavity. Plastic surgery of the inguinal canal and layer-by-layer suturing of the postoperative wound are performed. An important point is that polypropylene meshes are not used in children.

In the modern world, endoscopic inguinal hernia repair is increasingly performed, including in childhood, and they have a number of advantages over open operations:

Less surgical trauma.
The level of relapses, postoperative complications is lower.
The ability to perform the operation simultaneously on both sides.
More pronounced cosmetic effect.

But unfortunately, not every medical center has the necessary medical equipment.

Postoperative period

After surgical treatment, the patient stays in a hospital for 2-3 days, then he is discharged for outpatient treatment. In the area of the postoperative wound, as well as the scrotum, tissue edema may appear, which gradually decreases within 5-7 days.

Dressings are performed once every two days, it is forbidden to wet the wound, if the dressing is wet or dirty, it should be replaced. The sutures are removed on the 7-8th day, most often in children they use a cosmetic suture with absorbable thread, therefore, there is no need to remove the sutures. On the first day, it is allowed to give water, unleavened broths to drink.

In the absence of postoperative complications on the second day, the child can be given his usual diet. In the first month, it is recommended to limit the child as much as possible from stressful situations that can lead to severe crying; in older children, limit physical activity for one month.

An inguinal hernia is a condition in which the hernial sac protrudes through the peritoneum. Inside the bag are the internal organs, so their location changes, and their functions deteriorate.

And now let's dwell on this in more detail.

What is an "inguinal hernia"?

A hernia can occur in different areas, with inguinal localization, the bladder and intestines usually come out. This happens through the inguinal gap, which is located between the muscles and ligaments. In girls, the ligament of the uterus can also enter the hernial sac, and in boys, the spermatic cord.

Pathology is congenital and acquired. It often occurs in premature babies. The protrusion itself can be painless, however, during physical exertion, pain is felt and symptoms of disturbances in the functioning of internal organs occur.

Complete disposal of a hernia is possible only by surgery, which is recommended for children whose pathology is visible from birth. Often the disease is combined with others - dropsy of the testicle, hip dysplasia, spinal anomalies. In boys, the problem occurs several times more often than in girls. This is due to the peculiarities of intrauterine development, during which a channel is formed for lowering the testicles into the inguinal region. Normally, the hole should close, if this does not happen, an inguinal hernia occurs. Clinical manifestations are not always noticeable immediately and may appear during the life of the child.

The danger of the disease is that during physical activity, a hernia may be infringed, after which the internal organs do not retract themselves into the peritoneum. This leads to their dysfunction and the appearance of additional symptoms.

What does an inguinal hernia look like in children with a photo

The degree of protrusion with a hernia can be different. Often it is imperceptible in the supine position and appears only when the muscles of the peritoneum are tense, for example, while the child is crying or laughing. In boys, a hernia is similar to dropsy of the testicle, in girls it has a more characteristic appearance. Examples of inguinal hernia are shown in the photo below:

The first signs of an inguinal hernia

Congenital inguinal hernias are noticeable immediately after birth. The first sign is a protrusion of the skin in the form of swelling. It is painless, has a rounded shape and can completely disappear in a calm state of the child. With a large size of a hernia, it is not difficult to notice it, with a small one, it is detected a little later, when the child begins to be active or cry.

Hernias are right-sided and left-sided. In some cases, a pathological protrusion is formed on both sides. In addition, oblique and direct formations are distinguished, and several types are distinguished, depending on the degree of mobility, which is important for the doctor.

Symptoms of an inguinal hernia

The swelling itself is painless, however, during the movement of organs through the hernial fissure and back, the child may experience discomfort. Some complain of pulling pains, others - of a feeling of heaviness in the lower abdomen.

In boys, a hernia leads to stretching and asymmetry of the testicles. In the place of localization of the hernia, the scrotum will be enlarged. In girls, this is observed with the labia - one of them will be clearly larger. Hernial protrusion does not always descend into the genitals, but may remain in the lower region of the peritoneum. In this case, the swollen ball will be seen much better. More often the protrusion occurs on the right side.

Organs trapped in the hernial sac can be compressed during movement. This leads to the infringement of the hernia and the closure of the organs on the outside of the peritoneum. This condition is accompanied by circulatory disorders, increased intra-abdominal pressure, flatulence, and pain.

When an infringement occurs, the child begins to cry sharply, becomes restless and complains of pain. The bulging area cannot be set back, becomes hard, tense and painful. Almost always, the intestines get into the hernial sac, so its infringement leads to intestinal obstruction. As a result, the child develops bloating, an inflammatory process develops, and later necrosis of the walls of the organ. In the absence of urgent care, there is a possibility of perforation of the intestinal wall and the development of peritonitis.

Especially dangerous is the violation of the blood supply, which occurs when infringed, for girls. Inadequate nutrition of the tissues of the ovary and genital organs leads to the death of eggs and necrotic processes.

Causes and prevention of inguinal hernia

In children, inguinal hernias are predominantly a congenital feature. At the stage of fetal formation, the child has a vaginal process, which at the 12th week of development resembles a protrusion. After performing its functions, the process overgrows, and violations of this process lead to the formation of cracks and the appearance of a hernia after birth. Premature babies are more likely to develop a hernia because the area does not have time to heal. This process is the hernial sac into which the internal organs enter: in girls - the intestines, ovary and fallopian tube, in boys - the intestines, spermatic cords.

It is believed that the disease can be inherited. Approximately 11% of children with inguinal hernia had a relative with a similar pathology.

It is widely believed that a hernia can be acquired if the child carries heavy weights or cries too much. In fact, this happens very rarely. Basically, acquired pathologies can be in boys of school or transitional age who are engaged in strong physical exertion and at the same time have congenital weakness of the abdominal wall.

Thus, an inguinal hernia is formed even before the birth of a child, but the pathology can increase in size with intense physical exertion, which is why many consider the hernia to be acquired.

Of the provoking factors that lead to the protrusion of the hernial sac, doctors distinguish the following:

cystic formations in the ovaries or spermatic cords;
hip dysplasia;
problems with the spine;
obesity;
constipation;
coughing.

Hernia prevention includes timely detection of pathology and regular visits to specialists to monitor the dynamics of hernia development. Children are advised to exclude the provoking factors that are described above, and then the number of protrusions and pinchings will be much less.

To prevent an acquired hernia, it is recommended to take care of the overall health of the child. This includes moderate physical activity, which will help strengthen the abdominal muscles, the treatment of constipation, as well as proper nutrition to normalize the functioning of the gastrointestinal tract.

Diagnostics

Usually a hernia is diagnosed immediately after the birth of a child. Pathological protrusion is noticed by the parents themselves or is detected by the doctor during a routine examination of the baby. An accurate diagnosis will require the results of instrumental studies, visual examination and palpation, as well as anamnesis.

To make it easier to identify a hernia, the child is asked to bend over, strain, or cough. With tension in the abdominal muscles, the protrusion becomes more noticeable. After this, the child is asked to take a horizontal position. With an uncomplicated hernia, the internal organs are easily set back into place. If the intestine enters the hernial sac, then when it moves from the peritoneum and back, characteristic rumbling sounds can be heard.

After a preliminary diagnosis, the doctor sends the child to do an ultrasound. Ultrasound examines the pelvis, inguinal canals and peritoneum.

The specialist must also differentiate an inguinal hernia from other diseases that have a similar appearance (inguinal, femoral hernia, spermatic cord cyst).

Treatment of inguinal hernia

Only unimpaired hernias can be set back. If the organs are still pinched, the pathology is corrected only by surgical intervention. The quality of the result depends on the degree of neglect of the process and the stage at which treatment begins. Conservative therapy is theoretically possible, but is not currently used. It involves the constant wearing of bandages or compression underwear, which will prevent the organs from protruding outward.

Small children are operated on at the age of 6-12 months. The procedure consists in cutting off the hernial sac and restoring the normal anatomy of the inguinal canal. This may also require strengthening the affected area with your own tissues.

Surgical treatment can be carried out in an open way and with the help of laparoscopy. The second technique is preferable, as it has fewer side effects and requires minimal tissue incisions. When carrying out the procedure, the surgeon must be careful not to damage the spermatic cords, otherwise this will impair the reproductive function.

The operation is performed by a doctor in a hospital, and if the outcome is successful, the child can be transferred to home treatment.

When infringing the hernia of girls, an emergency surgical intervention is indicated, since there is a high probability of ovarian atrophy and impaired reproductive function. If a hernia is infringed in boys, measures can be taken for self-reduction of organs:

take a warm bath;
take antispasmodics to relax the muscles and expand the hernial gap;
position the child horizontally or lift his pelvis up to make it easier for the organs to “return”.

The prognosis for a child with an inguinal hernia is, in most cases, favorable. In uncomplicated conditions, surgical treatment is very effective. Before surgical reduction of pinched hernias, it is necessary to first make sure that the organs are viable. If their blood supply was severely impaired, and necrotic areas appeared, the doctor performs a resection.

Complications

As a complication, a pinched inguinal hernia and the consequences that such a condition leads to are considered. It is impossible to predict the pinch in advance. It is a jamming of the internal organs between the muscles of the peritoneum, so that they are sticking out. In this case, the muscles often spasm, which is why it is impossible to return the contents of the peritoneum back. This often occurs when the intestinal loop is overcrowded, which got into the hernial sac and fell out after physical exertion.

When a child is pinched, urgent prompt assistance is required. The process is acute and occurs suddenly. The child suddenly experiences severe pain in the groin, feels nausea and seizures. The area of the hernia that sticks out from the outside becomes hard and unreducible. The patient's condition deteriorates sharply and rapidly.

In addition to pain, pinching is dangerous because it prevents normal blood flow in organs that are outside the peritoneum. Within a few minutes, tissue appears in them, and after a few hours, necrotic processes develop. In 10% of cases with pinching, doctors diagnose gangrene. Such conditions are dangerous to the life of the child and can be fatal if timely assistance is not provided.

If parents are offered a hernia operation while the child is still young, they should agree. As you get older, the chance of pinching will increase. In addition, the baby will have to limit himself in many ways in everyday life until he gets rid of the problem. An inguinal hernia does not go away on its own and in any case it will have to be removed at some age.

Rehabilitation

After surgery, for the first time, the child is recommended to rest so that the work of the internal organs is restored and returned to normal. About a month later, doctors say to do special physical therapy exercises to strengthen the muscles of the abdominal wall and accelerate tissue regeneration.

It is recommended to add breathing exercises to special physical exercises, which improves homeostasis and the overall immunity of the child. A month after surgery, the doctor may allow you to visit the pool or engage in active walking.

It is very useful to attend massage sessions. Their goal is not only to strengthen the abdominal muscles, but also to normalize intestinal motility. Massage movements are performed in the navel, groin, oblique abdominal muscles, as well as on the back along the spine.

Sometimes doctors recommend taking mild laxatives to avoid straining and straining the operating area during a bowel movement. Absolutely safe drug for children of any age is Dufalac. As an aid, postoperative bandages can be used. They need to be purchased in specialized places, taking into account the individual size of the child.

Inguinal hernia in children is often congenital in nature, a protrusion of the navel appears in a newborn from the first days of life, and even then it is necessary to take therapeutic and preventive measures to quickly get rid of the defect and prevent progression. The disease in girls is diagnosed less frequently, and more often in preterm infants, due to a genetic predisposition.
Acquired hernias in a child under one year old practically do not occur, they begin to form at an age when the body already has a high physical load. In the formation of a protrusion in girls or boys up to one year old, the vaginal process takes part, which acts as a conductor of the gonads into the scrotum from the peritoneum. In a healthy child, it is gradually overgrown, but a violation of the normal process that occurs in premature babies creates favorable conditions for the appearance of a protrusion in the groin area, both in girls and among boys.

In children up to a year, this process simultaneously acts as a hernial sac, in which the organs of the peritoneum are located: the omentum, intestinal loop, fallopian tube or ovary in girls. In this case, the hernial ring forms the ring of the groin canal.

Types of disease

Congenital pathology in the groin in children is oblique or direct, as well as right-sided or left-sided. An oblique hernia in a child under one year old passes through the inner ring of the inguinal canal, straight lines are relatively rare and pass through a muscular opening in the wall of the peritoneum in the projection of the inguinal ring. In boys under one year old, a right-sided oblique hernia is more often diagnosed (60%), direct protrusions form with age. A severe clinical case of a hernia in a one-month-old baby is a bilateral hernia, which occurs more often in girls.

Only boys up to a year old have inguinal-scrotal hernias, when the testicle is squeezed, which in the future can lead to male infertility. Inguinal-scrotal hernia is divided into testicular and cord (diagnosed in 90% of cases).

The reasons

The direct causes of a defect in a premature baby lie in the underdevelopment of muscle tissue, incomplete closure of the abdominal opening. This disease does not occur among healthy boys and girls, therefore, every child with a hernia up to a year is examined by a pediatric surgeon to find the true cause. About 15% of newborns with hernias up to one year old had a genetic predisposition, so parents with an inguinal hernia should be prepared for the birth of a child with such a defect.

Inguinal hernia in children is not dangerous as long as it is controlled by parents and doctors, therefore, from birth, it is necessary to take therapeutic measures to prevent complications, given that congenital protrusion does not always go away on its own. The anatomical features of the child's body may not allow self-healing, even if all the rules are followed.

The pathology of muscle tissue in premature babies leads to complications if the doctor's recommendations are not followed. The cause of the complication is the tension of the child during screaming, crying, the wrong position of the body during sleep. In case of complications, it is necessary to perform an operation, but in 95% of cases it is possible to get rid of the defect without surgical intervention.

Clinic and diagnostics

A hernia of the inguinal region looks the same in girls and boys: on one or both sides there is a bulge in the form of a bump, which reaches up to 5 cm (may increase during stress). When you put the child on his back, the protrusion disappears, but in a standing position or while crying, it sticks out as much as possible. When pressing on the inguinal hernia in children, the protrusion also disappears, which does not happen if the organs are pinched in the hernial sac.

How does an inguinal hernia manifest in a child?

The protrusion is painless, rarely accompanied by aching pain in the lower abdomen, which may be the reason for the constant crying of the child and even more protrusion of the hernia.
The hernia has an oval shape, with an inguinal-scrotal hernia, the defect descends and compresses the scrotum, which leads to the asymmetry of one of the halves. In girls, a prolapsed hernia can lead to an enlargement of the labia.
Symptoms with complicated protrusion change: sharp pain joins, an increase in the defect, the impossibility of repositioning. Pinched organs in the hernial sac leads to circulatory disorders, ischemic changes occur. With such manifestations, an operation is urgently needed and then the inguinal hernia in children is completely eliminated.

Accompanying symptoms of complicated pathology are: intestinal obstruction, which is preceded by constant constipation, vomiting, bloating.

Important! Premature girls have a high risk of egg death due to ovarian necrosis during pinching, because this complication can serve as a factor in reproductive dysfunction in the future.

What to do with a hernia?

Conservative treatment of inguinal protrusion up to a year includes wearing a support bandage, bandages, surgery should be done immediately in case of infringement. In a planned manner, the operation is performed up to six months and consists in cutting off the hernial sac to restore the normal anatomical structure of the inguinal canal and peritoneal organs. During the operation, the doctor may install a mesh or strengthen the inguinal canal with nearby tissues.

The operation of children requires special care, the surgeon must exclude accidental injury to the spermatic cord in boys, otherwise the reproductive function will be impaired. After opening access to the pathological site, the viability of the organs located in the hernial sac is assessed. In case of tissue necrosis, the surgeon resects part of the intestine or omentum.

After the operation, it is recommended to do gymnastics, massage procedures, swim with the child in the pool to prevent relapse. A recurrence of the disease can occur already in an adult, but after the operation with the installation of a mesh, this happens extremely rarely.

How treat inguinal hernia in children And in what cases it is possible to do without operation? Today we will talk about what modern treatment of inguinal hernia in a child completely eliminates the problem and does not adversely affect the functioning of adjacent organs.
An inguinal hernia is a tumor that has arisen in the groin area. If the formation has spread to the scrotum, the hernia becomes inguinal-scrotal. In this tumor (hernial sac) is the ovary, omental strand, intestinal loop, and other organs. If you press on the hernial sac, you can hear a kind of rumbling, then the formation disappears, reduction occurs.
Often in children diagnosing oblique inguinal hernia. The disease proceeds in the same way as a cyst of the spermatic cord or dropsy of the ovary communicating. The vaginal process of the peritoneum (wide, not overgrown) acts as a hernial sac, which connects the abdominal cavity and the scrotum. From the abdominal cavity through the process, everything is displayed in the inguinal canal. Inguinal hernia in children- a fairly common disease in our time and in most cases is indicated hernial sac removal surgery to avoid the destruction of the structure of the inguinal canal under the pressure of a hernia that grows with age.

For a child, an inguinal hernia is a serious ailment that needs to be treated. The use of recipes from traditional medicine in most cases exacerbates the problem. In babies, hernias are predominantly congenital, arising from weak muscle tissue in the anterior part of the peritoneum. Doctors notice them immediately after the baby is born. Sometimes muscle weakness is due to the prematurity of the baby, not all organs are sufficiently developed in him.

When an inguinal hernia is found in a child You should immediately consult with your pediatrician. After the examination, he will explain how to deal with the disease in a particular case.
Inguinal hernia is eliminated with the help of operations, which is performed on a small patient no earlier than six months. When exactly - the pediatric surgeon decides.

But if the inguinal hernia in a child is restrained, then it should be corrected immediately. In the event that this is difficult to implement, an urgent surgical intervention is indicated (within 6 hours from the moment of infringement).

Herniotomy is done to the baby on the day he went to the hospital. During the operation, the surgeon removes (sutures) the hernial sac, sets the displaced organs, returning the normal structure of the inguinal canal. The spermatic cord and the vas deferens are partially connected to the hernial sac, the male patient must be operated very carefully.

An umbilical hernia is almost never infringed, here you can often do without surgical intervention. Girls are operated on if the umbilical ring is expanded. Now bloodless operations, without incisions, are becoming popular. Children tolerate them well, do not feel severe pain and do not face complications. Mom during the operation next to the child. The body quickly recovers, after a couple of hours you can return home.

It is important to keep in mind that inguinal hernia in children is a very dangerous disease and if you find obvious symptoms of an inguinal hernia in your child, you should seek qualified help from a pediatric surgeon as soon as possible. Only a specialist should decide what kind of treatment the baby needs. In some cases, it is enough to perform reduction (at an early stage of hernia formation). But in most cases, an operation is indicated to restore the anatomy of the abdominal canal as quickly as possible and remove the hernial sac.

Now you know how dangerous inguinal hernia in children and what treatment necessary when a child has this disease. If you have a child with an inguinal hernia, immediately contact a qualified doctor and in no case self-medicate - any non-traditional folk remedies can only aggravate the situation and cause serious harm to the health of the child.

Next article.

An inguinal hernia in a child is a defect of the abdominal wall, located in the inguinal region and characterized by protrusion of the internal organs outward through the formation of an oval protrusion. By increasing intra-abdominal pressure and expanding the inguinal canal, all organs located in the peritoneum, fatty tissue can protrude outward, thereby causing discomfort and pain in the groin.

An inguinal hernia can be either congenital or acquired. Hereditary predisposition to the formation of this formation is due to the fact that the low strength of the connective tissue that forms the muscular-tendon canal is not able to restrain intra-abdominal pressure. Acquired hernia, on the contrary, develops due to heavy lifting, systematic constipation, impaired urination and chronic cough.

The main factors contributing to the development of inguinal hernia include:

Genetic, age and sex predisposition. The fact is that if a pathology was diagnosed in the anamnesis of the closest relatives, then the likelihood of its occurrence in a male infant increases several times. The same risk is observed in the elderly, because over time, the tone of the abdominal muscles decreases significantly.
Obesity or excessive asthenia;
More than 3 births;
With the systematic performance of hard physical labor.

Even after surgery, the risk of recurrence of the pathology tends to 100% if the patient does not change the type of work (as for adults). Diseases accompanied by a constant cough can also provoke the development of an inguinal hernia. For example, chronic obstructive pulmonary disease, bronchitis, etc.

Classification

According to the clinical classification, protrusions are divided into:

Direct. Refers to purchased. Their main characteristic is the formation of a protrusion of the peritoneum directly through the inguinal canal, while skirting the spermatic cord.
Oblique. They can be either congenital or acquired. Their main characteristic is that the contents of the hernial sac enter the inguinal canal through the inner ring and pass close to the spermatic cord.

Inguinal hernia in pediatric patients is much less common than in adults. Despite this, every parent should remember that if any incomprehensible changes appear on the child's body, it is necessary to seek medical help.

Symptoms and signs

Complaints of patients directly depend on which organs were infringed during the formation of a hernia, on the size of the sac and the development of any complications. As a rule, the main symptom of pathology is the presence of a protrusion and its soreness.

The collected complaints determine the features of an individual approach to the further algorithm for performing an inguinal hernia operation in a child or adult. During an objective examination of the patient, attention is paid to:

the size of the spherical formation in the groin area;
determination of the intensity of pain during palpation of the abdominal cavity and protrusion;
the presence of rapid two-stage urination, which is a sign of involvement of the bladder inside the hernial formation.

In some situations, a hernia can repair on its own, especially when patients lie on their backs. If it is impossible to reduce the hernial contents into the peritoneal cavity, it is customary to talk about its irreducible variety.

Diagnostics

In most cases, the diagnosis of a hernia in the groin does not create any difficulties: a visible protrusion can be easily detected during a physical examination.

With the development of a volumetric hernial formation in males, as a rule, one half of the scrotum increases, its skin stretches, and the penis deviates in the opposite direction.

If untimely seeking help, the hernial sac can grow to gigantic sizes. and completely hide the penis in the folds of the skin.

During palpation, the specialist evaluates the shape and volume of the hernial sac in the position of the patient lying and standing. In total, there are two options for its location:

oblique hernia - the protrusion has an oblong shape and is located in the region of the inguinal canal (along its course), in some situations it can move into the scrotum;
direct hernia - a formation that has a round or oval shape and is located in the region of the median part of the inguinal ligament.

If the protrusion is located above the site of the projection of the external opening of the inguinal canal, then it is necessary to carry out differential diagnostics with periinguinal and interstitial hernia. In the presence of two protrusions, the development of a combined hernia can be suspected.

Where the danger lurks

pinching of the hernial sac;
development of intestinal obstruction;
the occurrence of an inflammatory process between the sheets of the peritoneum (peritonitis);
bleeding;
the spread of inflammation in the scrotum;
development of an unreduced hernia.

Conservative treatment

At the moment, the bandage is a scourge among patients and parents of children who have undergone the formation of this pathology. The fact is that this device helps to reduce the load on the inguinal region and reduce pressure in the hernial sac. The use of a bandage can have a therapeutic effect only with a reduced hernia at the initial stages of the disease.

The use of this type of canning therapy in children can lead to the development of the following consequences:

growth of the area of hernial protrusion due to tissue scarring;
compression of the contents of the hernial sac;
development of atrophy in the area of fascial edges;
compression of the spermatic cord.

Treatment of inguinal hernia in children without surgery is possible, however, the indications for its implementation should be justified solely by a specialist based on the history and diagnosis. Movement is life. This statement should be remembered by every parent and in order to prevent the development of inguinal hernia in children with a predisposition to this disease, instill a love for sports from childhood. Thanks to systematic exercises, the abdominal muscles will get stronger, and the risk of hernia formation will decrease.

Methods of surgical treatment

At the moment, the three most common methods for the surgical treatment of inguinal hernia in children are used. These include:

Stretch method. When using this method, the removal of the hernial sac occurs through the use of the patient's tissues. The edges of the formed defect are subsequently tightened with a seam. Today, this technique is used less frequently due to the high risk of recurrence and the difficult recovery period.
Tension-free hernioplasty. The hernia defect is eliminated by using a special synthetic mesh, which plays the role of a kind of frame and barrier that prevents the recurrence of a hernia.
Laparoscopy. This is the most gentle surgical intervention. Through several small incisions, trocars, an endoscope and the necessary instruments are inserted into the abdominal cavity. Meshes are also placed using laparoscopy.

At present, it is becoming more and more common one day surgery. Laparoscopic surgery for hernia in children is a method of treatment with minimal tissue trauma and the shortest recovery period.

Whether an operation is needed if the patient is diagnosed with an inguinal hernia is described in an interview with a practicing surgeon.

Ultrasound procedure

In pediatric patients, as a rule, ultrasound examination of the inguinal canals and scrotum is used for diagnosis. Thanks to ultrasound, the following features can be determined:

localization and size of hernial formation;
determination of the internal organs involved in the pathological process;
condition of the walls and openings of the channel.

Also, thanks to ultrasound, it is possible to determine whether the ovaries and fallopian tubes are affected, and what part of the intestine is located in the hernial sac.