An inguinal hernia is the bulging of abdominal contents from a weak area in the lower abdominal wall. Inguinal hernia occurs in 1-4 in 100 children. In premature babies, it can develop in 10 out of 100 children. It can occur bilaterally in about 10% of boys and 30% of girls. Bilateral inguinal hernias may require two surgeries at different times. From Memorial Antalya Hospital, Department of Pediatric Surgery, Prof. Dr. Osman Zeki Karakuş shared what should be known about inguinal hernia and its treatment in children.
The canal must be closed after birth
Karakuş said that inguinal hernias are generally direct types usually seen in adults and indirect types mostly seen in children: “There is an inguinal canal through which the testicles pass in boys and the ligaments that suspend the uterus in girls. This canal, located between the abdomen and groin, must be closed after birth. We speak of inguinal hernia when the intestines or other intra-abdominal organs enter this canal because this canal remains open.
May not always be noticed
Prof. Dr. Osman Zeki Karakuş, pointing out that a hernia can be noticed immediately after birth as swelling in the groin area and testicular sac, said: “It can be noticed as a swelling in the groin that does not disappear at birth appears, but then occurs suddenly during activities that increase intra-abdominal pressure, such as straining, coughing, crying, and jumping from a height. A strangulated hernia, called an incarcerated hernia, occurs when the intestines become compressed in the inguinal canal in the groin. In this case, a hard and constantly painful swelling develops in the groin. The child has constant groin pain, restriction of movement, and discoloration such as bruising in the swelling over time. Babies may complain of constant crying, restlessness, pulling their legs to their stomachs, not sucking and vomiting. Inguinal hernia is not always seen. For this reason, it is very important that the family immediately take a picture of the swelling in the groin at the time of diagnosis.
Blackbird, a feeling of pain and discomfort that improves with rest, heaviness or pressure in the groin, burning sensation at the site of the protrusion, fussiness and feeding problems in infants, nausea and vomiting, fever, a red or pale blue-gray swelling that is PUBLIC soft, his size when your child cries He said that complaints such as constant swelling could be a sign of an inguinal hernia.
“There is no cure other than surgery”
Referring to the treatment methods, Karakuş said, “First of all, there is no treatment for inguinal hernia with drugs or any method other than surgical repair. Although not urgent, surgery should be performed as soon as possible, as it is not clear when the intestines or the ovaries and fallopian tubes enter the canal in girls and drowning will occur. When the hernia strangles, damage to the intestines or, in girls, ovaries and fallopian tubes, can lead to gangrene. This results in a larger operation in which the gangrenous organs are removed through the abdomen. Because the blood supply to the testicles in men stops due to suffocation, the risk of gangrene in the testicles also increases.
“It is important to understand if there is a herniated disc on the other side”
Prof. Dr. Osman Zeki Karakuş continued his words as follows:
“In the classical method, the operation is performed with an incision of about 2-3 cm in the groin on the side of the swelling. It is introduced up to the canal and the opening is closed with sutures. This method requires several attempts to understand if there is a hernia on the other side. If there is a bilateral hernia, an inguinal hernia develops on the other side in the period after the operation, which puts a second operation on the agenda.”
Surgery can be performed by entering with a camera
Continuing to provide information on treatment methods, Karakuş said: “Another method is inguinal hernia repair with a closed method called laparoscopic, which is usually applied with two or three instruments. The inguinal canal is closed with sutures through the abdomen by entering only from the navel with a single device with a camera. The advantages of this method are that both inguinal canals can be seen and it is possible to repair bilateral hernias in the same operation. In addition, because it is made with a smaller incision in the navel, it can be completed without a visible scar, with less pain and a faster recovery time.
“The child can be discharged on the same day”
prof. Dr. Karakuş said: “Although it generally requires standard surgical preparations, he can go home the same day after a follow-up of approximately 4-6 hours post-surgery. After surgery, no obvious pain and limitation of movement are seen in children and additional medications and other treatments are not necessary. Although surgically repaired, there is a possibility of recurrence of inguinal hernia. However, the recurrence rate of an inguinal hernia performed with the correct method and procedure is less than 3 per thousand.