A hernia is a bulge that has formed when the internal organs of the body push through a weak spot in the abdominal wall. There are different types of hernias based on their location.
An inguinal hernia is an abnormal bulge of a section of intestine and fluids in the groin region. In children, an inguinal hernia is present from the time of birth. It is caused by a weakened spot in the abdominal wall when an opening in the wall does not normally close before birth.
The herniated intestine usually moves in and out of the weakened wall, and may be noticeable only when your baby coughs, cries or strains during bowel movements. Sometimes the intestine gets trapped in the opening (incarcerated hernia) and blood flow gets blocked (strangulated hernia), leading to tissue damage and complications. The most common symptoms are sudden pain, swelling or burning, nausea and vomiting. When you present with these symptoms, your child's doctor performs a thorough physical examination.
Treatment for inguinal hernia is usually surgery, performed under general anesthesia. A small incision is made on the groin's skin fold to identify the bulged intestine. Your child's surgeon then gently pushes the intestine back into its proper position behind the muscle wall. The hernia sac is removed and the incision is closed with stitches to prevent recurrence.
Umbilical hernia is a bulge that forms near the navel or belly button, when a part of the intestine, fat or fluid is pushed out through a weakened muscle of the abdomen. It is commonly found in infants and young children, especially in premature babies. The umbilical cord passes through a small muscular opening in the baby's abdomen during pregnancy. Sometimes, the muscles of the umbilical opening fail to close completely after birth. This leads to a weak spot near the navel, which allows internal organs of the abdomen to push through it.
The hernia may be noticeable in babies when they cough, cry or strain the abdomen, and may wane off or reduce while lying down or staying calm. This type of hernia is generally not painful in children. Umbilical hernias have a risk of getting trapped and strangulated, thereby cutting off the blood supply to the trapped part.
Physical examination is generally conducted to determine the size and prominence of the umbilical hernia. In children, the hernia generally resolves by 18 months. Your doctor may wait for a while before suggesting surgery. Indications for recommending surgical repair in children include:
- Painful, trapped or strangulated hernia
- Hernia fails to close by 5 or 6 years
- Large hole near the navel (greater than 1 inch in diameter)
The surgery is performed under general anesthesia. Your child's surgeon makes a small incision under the belly button. The herniated tissue is gently pushed back into the abdominal cavity and the incision is closed with dissolvable sutures. A mesh may be stitched in place to strengthen this area in order to prevent recurrence. The common risks associated with the surgery include infection and recurrence of the hernia.