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Yeditepe University Hospital Department of Pediatric Surgery Assoc. Dr. Selami Sözübir, very common in children, lananInguinal hernia in children, is a dangerous or even insidious disease. Especially because of the risk of choking the intestine entering the hernia may require emergency surgery. Therefore, in case of doubt, the physician should be consulted immediately. ”
The inguinal region is the most common site of pediatric surgery. Among these, inguinal hernia repair is the most common operation in both pediatric surgery and groin region. Inguinal hernia in children differs from adults in both its formation and type and repair technique. About 3 out of 100 boys develop inguinal hernia. Hernia is more common in preterm or low birth weight babies.
The testes of male babies (male eggs) complete their development in the mother's womb and make a descent downward through the abdomen where they first formed and settle in the egg sacs (bags) where they should be. This journey starts around 3 months and ends near birth. The testes that pass through the abdomen and out of the abdomen pass through the groin canal. It normally closes in the canal by losing its function with birth. However, if one or both of these channels do not close, herniation occurs. This swelling increases when the child is awake and mobile if the duct opening is narrowed and allows only intra-abdominal fluid to pass. When the child sleeps and sleeps calmly, it may diminish or disappear. Known as sel Hydrocele Tıp in the language of medicine, the name of this disease among the people is “Water hernia”.
If the remaining canal is large, the organs in the abdomen and most commonly the intestinal hernia develop from this canal. That's the real groin hernia.
There may be swelling in the groin and egg sac. It does not cause pain, but it can cause restlessness, discomfort and sometimes vomiting. Inguinal hernia may occur not only in boys but also in girls. However, in girls, inguinal hernia is less common and in girls, the ejected organ is mostly ovary, not intestine.
It is more common in males, low birth weight, premature infants and children with some congenital connective tissue diseases. The incidence of males is 5-6 times higher than females. Environmental factors such as chronic constipation and severe infections that increase intra-abdominal pressure do not directly cause inguinal hernia, but in some cases may cause inguinal hernia to become apparent.
The occasional swelling in the groin, which can be seen and disappeared in childhood, should bring to mind the inguinal hernia first. If a child has a suspicion of inguinal hernia, a pediatric surgeon should evaluate it as soon as possible and then confirm its diagnosis. Because in children, inguinal hernia should be treated with surgery as soon as possible, ie without waiting for a certain age or month. There is absolutely no age limit here.
Because inguinal hernia in children is a very dangerous and even insidious disease especially with the complications it may cause. Especially because of the risk of choking the intestine entering the hernia may require emergency surgery. Emergency surgery in children and especially in infants means increased risk. In this case, which is defined as strangulation of hernia among the people, the blood supply and feeding of the trapped organs entering the hernia sac will deteriorate within a few hours and decay occurs. This increases the life-threatening and means removal of rotting organs.
If the child is operated immediately after being detected without emergency conditions, this operation is not a difficult operation. We perform this operation as “daily surgery de in our hospital. A significant number of patients can go home about 2-3 hours after surgery and do not need to be hospitalized at all. In addition, this operation can be performed in both open and laparoscopic forms.
Delay in treatment may disrupt the testes for various reasons. First of all, untreated hernia may swell frequently, pressure the vessels or cause a temperature difference and disrupt the normal development of the egg. Another important cause of infertility is the damage of the testicles caused by the operation of this operation in the wrong hands and not suitable for children by adult imitation.
We have two groin channels, right and left, which can independently form a hernia. Therefore, there is always the possibility of a hernia in the other groin after unilateral surgery. This is not a repetition but a new hernia. If the child has developed a hernia on one side, there is a greater risk of being on the other side. In babies with this risk, we can also check if the hole on the other side is open by using the closed hernia hole without any risk to the child in the same operation in our hospital and if it is open, we will repair the side hernia in the same operation and eliminate the risk of the child having further surgery and anesthesia in the future.