This acute pathology, as the infringement of an umbilical hernia in newborn is a rare phenomenon, but represents a danger for the baby’s life. When it is found necessary to do emergency surgery. It is a compression of part of the intestine or omentum in Grajewo channel, which if untreated, can cause tissue necrosis and other complications.
The causes and mechanism of hernia strangulation
Umbilical hernia in newborns may be the result of premature birth, low weight and underdevelopment of the muscles of the abdominal wall, rickets or malnutrition. Can affect it and heredity. Its infringement in infants is rare due to the peculiarities of the muscular system of the abdomen.
Cause it can sharp increase in intra-abdominal pressure in the following cases:
- under intense coughing;
- during crying;
- constipation and attempts during bowel movements.
The navel of the child appears on the site of the umbilical ring, while in the womb, it passes through the umbilical cord. When a baby is born, the umbilical hole is contracted and covered with scar tissue, but sometimes it is not completely closed, which creates conditions for the outward protrusion of the internal organs.
In the case of increasing intra-abdominal pressure gryzenia gate expand and loops of bowel are extruded. Then gryzenia gate and bag constrict, penetrated into his organs are unable to reduce a backward and prone to infringement.
Umbilical hernia in children without complications may have no effect on their condition. The color of the skin over the defect is the same, it can easily be set manually. This pathology is allowed to treat conservative ways to 3 years. If by this age, the umbilical ring is not consolidated and was narrowing, there shall be a planned operation. If the hernia is not addressed it can result in complication such as an infringement.
The difficult state that infants can specify the following symptoms:
- severe pain during which the child is constantly is nervous and cries;
- temperature rise;
- hardness of the navel;
- tension the abdomen.
If not in time to see a doctor, it may happen necrosis of the bowel loops caught in the umbilical ring. It is dangerous to health and life of the child. The only effective therapy in this situation is emergency surgery.
What is the danger of a strangulated hernia in children
Infringement of umbilical hernia can cause a child’s bowel obstruction. This occurs when squeezed in hernial SAC of intestinal ring can not pass stool. Peristalsis of the intestines in pathology is also broken. Due to the inability of flatus and stool belly swells. And this affects the General condition of the infant and speeds up the heartbeat.
Another complication of strangulated hernia – abscess, which may appear some time after the infringement. Fabrics that were subjected to compression, can not fully nourished with oxygen and other valuable nutrients and rapidly begin to die. Against this background, joins a secondary infection.
There is a danger that the hernial protrusion is accompanied by swelling and increased body temperature. The skin in the area of the hernia becomes red or crimson. In the hernial SAC may contain pus, which is dangerous for health and can cause sepsis.
When the feces cannot pass the intestinal ring, muffled in the bag, begins to develop obstruction of the body. And even if it is possible to independently set the loop of bowel, the danger will not pass. On the walls of the intestine may remain affected by ischemia plots, they are able to heal on their own if they are small. Sometimes after reposition of the loop affected by ischemia may develop adhesive disease. The most dangerous consequences of infringement of a hernia become peritonitis and death.
Indications for surgery
In the absence of complications in newborns, it is possible to cure a hernia without surgery. If conservative methods do not help, then elective surgery is assigned to 3 years of age.
But in extreme cases it is used even infants in the following cases:
- when symptoms of necrosis of the intestinal walls;
- intestinal obstruction;
- in advanced symptoms of intoxication;
- if it is impossible to straighten the bodies left in the bag;
- when the seal protrusion.
But even surgery has a number of contraindications.
Before its implementation, the doctors must determine whether the child has disorders of the cardiovascular system and respiratory system. In addition, the number of contraindications the following:
- kidney failure;
- infection in the acute form;
- disorders of the liver.
To exclude the possibility of complications after surgery, you need to find out in advance whether a baby contraindications to the intervention.
In preparation you need to undertake the following:
- to make the blood and urine;
- to perform an abdominal ultrasound;
- to do chest x-rays.
The physician prescribed and other studies that will predict how you will behave in the body after the procedure and can it be do.
Newborn surgery to remove a strangulated hernia is performed under General anesthesia with the use of tools allowed kids at this age. The operation itself can be carried out by the method of hernioplasty or laparoscopic surgery.
The appointment of a specialist strangulated hernia in newborns is removed by hernioplasty. It happens this way:
- 1the Child is doing the anesthesia and wait for the start of its action.
- 2Directly in place of the bulging hernia SAC incision of the skin.
- 3To in the future no cosmetic defects of the skin, the umbilicus should be left untouched.
- 4hernial SAC is peeled from the dermal tissue, the procedure is performed in place of the neck of the hernia.
- 5Organs in their right anatomical places. Then they are carefully inspected in order to identify and remove foci of necrosis.
- 6the Cervix is tied off with silk thread, and the bag is removed, the fabric layers sewn.
Hernia repair has its drawbacks. One of them is a long recovery, and the preservation of pain within 3 months following completion of intervention that gives the baby’s constant discomfort.
Laparoscopy compared with the previous method is more gentle. It is prescribed when there is ischemia of the tissues of the disadvantaged in the bag. The procedure involves 3 small puncture wounds in the abdomen, in which are introduced a special tube.
In one of these holes is placed an endoscope equipped with a light source and camera. In others introduce tools for the manipulation. These tools doctors reduce intestinal loops trapped in Gruziya gate. Why through the tubes enter the facility for stitches or a special stapler with staples.
RehabilitationThe recovery process after the procedure is short, and the child will not feel such pain as when hernioplastica.
Since we are talking about the operation of the newborn, the rehabilitation has its own characteristics. In most cases, after her mom left in the hospital for monitoring for 1 or 2 weeks. If after the procedure his pain, the little patient will cry and strain the abdominal muscles, which can leave seams.
To stop this from happening, a child can schedule an appointment sedative and analgesic agents that are appropriate for that age. To not have complications and did not develop adhesions, after healing of joints it is recommended to do a little patient a special massage, to take him to physiotherapy and physical therapy for infants.
The youngest in the majority of cases of uncomplicated umbilical hernias heal without dangerous consequences. To treat an umbilical hernia in newborns must be strictly according to medical recommendations in order to prevent its infringement. To breast feed or mixture so that the stomach does not accumulate gases and was not constipation. For this reason also it is recommended to consult with a specialist.
To the abdominal cavity is not bulged in gryzenia gate and not undermined, it is recommended to paste special patches.