Tuesday, June 14, 2011

Hernia in Children

Credit to:

(Children's Hospital Boston)



A hernia occurs when a section of intestine protrudes through a weakness in the abdominal muscles. A soft bulge is seen underneath the skin where the hernia has occurred.
In children, a hernia usually occurs in one of two places:
  • around the belly-button
  • in the groin area
A hernia that occurs in the belly-button area is called an umbilical hernia. A hernia that occurs in the groin area is called an inguinal hernia.


A hernia can develop in the first few months after the baby is born because of a weakness in the muscles of the abdomen. Inguinal and umbilical hernias happen for slightly different reasons.


Hernia (Umbilical or Inguinal)Inguinal Hernia
As a male fetus grows and matures during pregnancy, the testicles develop in the abdomen and then move down into the scrotum through an area called the inguinal canal.
Shortly after the baby is born, the inguinal canal closes, preventing the testicles from moving back into the abdomen. If this area does not close off completely, a loop of intestine can move into the inguinal canal through the weakened area of the lower abdominal wall, causing a hernia.
Although girls do not have testicles, they do have an inguinal canal, so they can develop hernias in this area as well.


Hernias occur more often in children who have one or more of the following risk factors:
Inguinal hernias occur:
  • in about one to three percent of all children.
  • more often in premature infants.
  • in boys much more frequently than in girls.
  • more often in the right groin area than the left, but can also occur on both sides.


Occasionally, the loop of intestine that protrudes through a hernia may become stuck, and is no longer reducible. This means that the intestinal loop cannot be gently pushed back into the abdominal cavity. When this happens, that section of intestine may lose its blood supply. A good blood supply is necessary for the intestine to be healthy and function properly.


Hernias usually occur in newborns, but may not be noticeable for several weeks or months after birth.
Straining and crying do not cause hernias; however, the increased pressure in the abdomen can make a hernia more noticeable.
  • Inguinal hernias appear as a bulge or swelling in the groin or scrotum. The swelling may be more noticeable when the baby cries, and may get smaller or go away when the baby relaxes. If your physician pushes gently on this bulge when the child is calm and lying down, it will usually get smaller or go back into the abdomen.

If the hernia is not reducible, then the loop of intestine may be caught in the weakened area of abdominal muscle. Symptoms that may be seen when this happens include the following:
  • a full, round abdomen
  • vomiting
  • pain or fussiness
  • redness or discoloration
  • fever
Symptoms of a hernia may resemble other conditions or medical problems. Please consult your child's physician for a diagnosis.


Hernias can be diagnosed by a physical examination by your child's physician. Your child will be examined to determine if the hernia is reducible (can be pushed back into the abdominal cavity) or not. Your child's physician may order abdominal x-rays orultrasound to examine the intestine more closely, especially if the hernia is no longer reducible.


Specific treatment will be determined by your child's physician based on the following:
  • your child's age, overall health, and medical history
  • the type of hernia
  • whether the hernia is reducible (can be pushed back into the abdominal cavity) or not
  • your child's tolerance for specific medications, procedures, or therapies
  • your opinion or preference
Inguinal hernia:
An operation is necessary to treat an inguinal hernia. It will be surgically repaired fairly soon after it is discovered, since the intestine can become stuck in the inguinal canal. When this happens, the blood supply to the intestine can be cut off, and the intestine can become damaged. Inguinal hernia surgery is usually performed before this damage can occur.
During a hernia operation, your child will be placed under anesthesia. A small incision is made in the area of the hernia. The loop of intestine is placed back into the abdominal cavity. The muscles are then stitched together. Sometimes, a piece of meshed material is used to help strengthen the area where the muscles are repaired.
A hernia operation is usually a fairly simple procedure. Children who have an inguinal hernia surgically repaired can often go home the same day they have the operation.


Once the hernia is closed, either spontaneously or by surgery, it is unlikely that it will reoccur. The chance for reoccurrence of the hernia may be increased if the intestine was damaged.
Back to Suhail.. Right after surgery.. he was in pain and kept screaming (as in my previous post http://mummyeda.blogspot.com/2011/06/ouch-ouch-ouchhhhh.html ) Around 1pm he started to walk around but only for an hour. The rest of the day.. he refused to walk until the next morning (today, June 14th).
We didn't give him any medication to relief his pain. He had a PCM supp during post operation..and that's all! We did request for it an hour after the surgery but the doctor ask us to wait at least  4-6 hours after the PCM was given. And.. by 1pm.. Suhail didn't scream nor having any pain complaint. So we just let it go...
As of today (14th June 2011)...
He was as playful and jaunty as ever. But around 3pm we noticed that he walked awkwardly and forbid us to touch his scrotum. Something was wrong....
Huh! It was swollen!!! Daddy gave him 5 ml of Brufen to relieve his pain...
The total cost for his operation and stays (mother & child - single standard) is RM3576.70 

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