Umbilical hernia in children is a common phenomenon. It is found in every fifth baby, and among the preterm infants – almost every third.
When parents are faced with this pathology, they get nervous. But it is a wasted emotion, because such a defect rarely is a threat for the baby and easy to treat.
In newborns the appearance of the umbilical hernia occurs as a result of a delay circuit of the umbilical ring (hernial ring) – hole through which passed the umbilical cord connecting the fetus with the placenta.
The main cause of pathology is the weakness of the abdominal muscles of a newborn.Other reasons:
- 1Violation of fetal development.
- 2Premature birth, when the baby is born premature.
- 3Genetic inheritance, weakness of the abdominal muscles.
- 5Infectious diseases of the mother during pregnancy, environmental contaminants, influenced the development of the fetus.
A causal factor is not the method of ligation of the umbilical cord.
A hernia can occur not only in the newborn, but later, due to the following reasons:
- intestinal colic;
- strong thinness;
- pathological constipation and flatulence;
- excessive physical stress;
- injuries of the abdominal cavity.
Pupkova hernia can occur if the child begins to walk early, when still not fully grown abdominal muscles. In rare cases, the pathology occurs for no apparent reason. In girls bulging belly button happens more often than boys.
In most cases, the pathology is easy to see. It is a protrusion with a diameter of 1-2 cm or more (sometimes up to 10 cm), round or oval. Some hernias have the appearance of the proboscis (chobotovskaya hernia). If the belly button sticks out slightly, it may be an anatomical feature, not a pathology (this phenomenon is called “skin of the navel”)
Hernia has the following characteristic features:
- 1Easy reduce inside.
- 2Is unobtrusive when the abdominal muscles are relaxed, but there is the slightest tension.
- 3Can change the color and density.
- 4gryzenia Through the large gate visible bowel loops and peristalsis.
Sometimes the extension of the umbilical ring occurs when the baby starts to cry. Hence arose the opinion that a hernia appears frequently crying baby. It is not, because the weeping and the laughter only provoke tension of the abdominal wall.
By itself, the pathology does not bother the baby, but is accompanied by constipation and flatulence, which are painful, so these babies are restless and sensitive to the weather: if the weather changes, becoming lethargic, sleepy or cranky.
Attentive parents noticed abnormalities in the area of the umbilical ring, going to the pediatrician. The final diagnosis set by the surgeon, he determines the method of treatment.
The main method of diagnosis is visual inspection and palpation of the peritoneum. To perform the differentiation with other pathologies with similar symptoms, conduct additional research:
- blood test;
- Ultrasound and x-ray of the abdomen;
- x-rays of the hernia SAC (herniography).
At small sizes hernia is invisible, then it can determine only an experienced doctor.
Umbilical hernia there are several types. At the time of occurrence of the pathology vary:
- congenital umbilical hernia;
- acquired at a later age.
If through the umbilical ring into the hernial SAC into the bowel loops, can occur when their fusion with the tissue of the peritoneum. So there or without reduction of the hernia.
A strangulated hernia occurs when a loop of intestine may not be able to get out of the umbilical opening, and thus there is compression of blood vessels. This pathology leads to the death of part of the bowel, bowel obstruction or peritonitis.
A method for the treatment of pediatric umbilical hernia depends on its size and development of complications. This files most often assigned simple conservative methods that baby moves easily. A congenital disorder is 1-2 years, but in some cases the process may be delayed. Sometimes used drug therapy.
But the most effective method of treatment is to strengthen the abdominal muscles. If gryzenia the gate is closed to 4-5 years, the question of surgical intervention.
Conservative methods of treatment for children more efficient than adults. If there are no complications, when properly selected methods of therapy-healing umbilical hernia occurs in 90% of cases.
The methods of conservative medicine are massage, therapeutic exercises, use a plaster and bandage. They are under the supervision of a physician, so as not to cause complications. All methods are used together. In the treatment of diseases in children under 5 years of conservative therapy plays a dominant role.
To folk treatments include applying a copper coin, conspiracy, compresses of garlic, onions, potatoes, etc. These methods do not solve the problem, they can even make it worse, delaying recovery. When using coins, often there are inflammatory processes on the skin. Than to apply a cabbage leaf, it is better to use a band-aid. Doctors do not recommend these methods of treatment because they developed new, effective and safe techniques.
Therapeutic gymnastics is conducted with the aim of strengthening the abdominal muscles. Like massage, exercises are performed before feeding and the fixation of the umbilical ring with a bandage or pressure bandage. Classes with infant carry out familiar people, the baby needs to be calm.
The first is the massage. Then the small spread on the abdomen, on the left and right side turn from back to stomach, raise legs. With age, the exercises become more complex, many of them kids have to do yourself. Gymnastics ends with a relaxing massage.
The use of plaster – the most common method. It does not require much time and special skills of parents. Start to seal the protrusion is possible after healing of the umbilical wound and in the absence of skin diseases.
You can’t use domestic adhesive, not intended for surgical procedures. It is best to use special products, which have the required characteristics. It’s a band-aid for umbilical hernia Chicco, Hartmann, Porofix, plate production of the Russian-Finnish company, Arelis. The last two brand practical and easy to use. Their design allows you to automatically generate the fold of skin over the umbilical ring, is needed to prevent protrusion.
Use stickers rates (often 10 days), remove them only while bathing. Some kinds of adhesives with water resistance, can be kept on the child’s body for a few days. Sometimes after treatment with Bandaids to secure the result we recommend wearing a brace.
If the hernia does not give complications, the operation is carried out in children after 5 years because before that age there is a chance of self-healing pathology. Kids in 2-3 years, surgical intervention is performed when indicated.
There are different types of operations. A hole is sutured. It is a simple surgical procedure that is sometimes done in a clinic. In other cases, doing hernioplastica (excision of a hernia). The minimally invasive method – laparoscopy. When a large diverticulum is performed open surgery using a special mesh.
Children up to 5 years operation is carried out, if there are problems, including:
- the large size of the hernia SAC (1.5 cm);
- change the color and density of the protrusions;
- chobotovskaya hernia (it does not respond to the conservative methods of treatment);
- the appearance of puffiness okonopatkoj region.
Girls this operation is carried out to prevent complications in pregnancy in the future.
Emergency surgery is done when there is infringement.
Disregard the advice of the surgeon regarding elective surgery can result in complications. In case of infringement of a hernia is a complex operation consisting of several stages, after which increases the risk of adverse effects.
All planned operations are going well, have about 1% of complications, which include:
- suppuration of postoperative wound;
- damage close to the belly button bodies;
- relapse pathology;
- complications after anesthesia.
If you have used the implant may shift. Least of all complications happen after a laparoscopy.
The duration of the rehabilitation period depends on the age of the child and the complexity of the operation. The short recovery period after hernioplasty by the method of laparoscopy – no more than 2 weeks. In the postoperative period of limited physical activity, lifting heavy objects, are excluded from the diet foods that cause flatulence. After the permission of the doctor appointed physical therapy, massage, physiotherapy.
In the prevention of navel hernia has great value food. If the child is breastfed, the woman is contraindicated the foods that cause flatulence in the child, and the baby is necessary as long as you can eat mother’s milk. More dangerous are colds, because crying and coughing cause the overexertion of the abdominal muscles.
To avoid Pupkova hernia in a child needs from infancy to pay attention to physical development.
A good preventive measure – gymnastic exercises, massage, swimming. You should always control the weight and physical activity of the child.
Olga, 26 years old, Pskov
We haven’t agreed to do five-year-old kid hernioplastica, but after reviewing the tips Dr. Komarovsky, still decided. The operation was done by laparoscopy under General anesthesia. The next day the son wrote. After surgery was no pain or complications. For the first time after operation the most difficult thing was to keep children from excessive physical activity.
Elena, 24 years old, Voronezh
When she was diagnosed with a hernia, it was a great shock. But it was not so scary. We had a massage and enjoyed a special patch. When my daughter started to walk for the prevention wore a bandage. Year defect navel disappeared.