Umbilical hernia in a newborn – symptoms,treatment

Update: October 2018

Umbilical hernia is a visible abdominal bulge.
walls (skin and peritoneum) due to a defect or weak tissue
брюшной стенки, а точнее – umbilical ring. With severe hernia in
abnormal protrusion (hernial sac) fall internal
organs – part of the omentum and loops of the small intestine, which can
turn into the pinching of these organs and tissue necrosis.

Umbilical hernia in a newborn is detected quite often –
this pathology is diagnosed in every fifth child,
born on time, and every third baby who appears on
light ahead of time. Children in the first days of life have a minimal defect or
weakness of the umbilical ring is found in almost every
case, but this feature is far from necessarily becoming
straight road to hernia – with the development of the baby, muscular and
connective tissue, and the ring acquires an anatomical shape.

True hernia is mostly detected already in the first month of life.
small person, but can be diagnosed and later, for example,
when the baby has already learned to walk.

Causes of umbilical hernia in children

The baby in the first minutes after birth, the umbilical cord is cut off,
this reduces the muscles surrounding the navel. Tied up part
the umbilical cord disappears 4-5 days after delivery, and the navel itself
is the place where the umbilical cord was bandaged. Under the skin
education – the navel – is the muscular umbilical ring, which
consists of lower and upper parts.

In the lower part passes the urinary duct and umbilical artery. Fabrics
the lower part of the umbilical ring is well reduced and form
dense scar tissue, not subject to defects. At the top
part of the ring passes the umbilical vein, the walls do not have muscular
shells and are thin, therefore are poorly reduced in
the following.

The tendency to the formation of a hernia in the navel in children laid
by nature itself

In some cases, hernia in children is caused by anomalies.
development of the umbilical ring that occurred during
intrauterine development.

Another factor in the emergence of a hernia in the navel is weakness
peritoneal fascia and cleft umbilical vein cleft. Fine
arteries and veins lose their function immediately after birth,
umbilical cord ligation causes anatomical collapse of the vessels and their
fusion. Non-overgrowth of the umbilical vein may be caused
anatomical features and also occur due to poor
bandaged umbilical cord, for example, at home birth.

Пупочная грыжа

An important factor leading to the occurrence of this pathology in
children, is the often repeated increase in intra-abdominal
pressure. There are many reasons for this – the frequent crying and crying of a child,
increased gas formation, constipation.

The leading cause of hernia in the navel –
genetic predisposition expressed in natural weakness
muscle tissue of the anterior abdominal wall. Often these kids
initially have a reduced muscle tone. If the baby’s parents
childhood suffered an umbilical hernia, the likelihood of this
pathology in the child itself is 70%.

Symptoms of umbilical hernia

Umbilical hernia can manifest itself immediately after the residue falls
umbilical cord Many parents pay attention to this feature –
baby’s navel sticks one or two centimeters farther than the belly line, and
immediately sent to the doctors. In many cases, these symptoms
is false and only indicates anatomical features
navel. But the fact that the pediatrician should seem is unambiguous
recommendation.

Primary manifestation of hernial protrusion often occurs when
strong crying and screaming child, during a coughing fit, with constipation.
A number of diseases such as hypotrophy, hypotension, rickets in breast
child (signs), create a favorable base for the formation
hernia at the navel, because they reduce the tone of the muscular system.

External manifestation of umbilical hernia – protrusion rounded or
oval shape the size of a cherry bone in the ring,
unobstructed back into the abdominal cavity. Due to
weakness of the muscle tissue of the anterior abdominal wall hernial
bulging may be accompanied by divergence of the rectus abdominis muscles.

The contents of the hernial protrusion or bag are usually loops
intestine. With a wide umbilical ring, as well as significant
the size of the hernia may be visible intestinal peristalsis –
contraction of the intestine and the promotion of food masses along it

Such a picture can greatly frighten parents, but the child in
such moments does not feel pain or any discomfort.
The size of the hernial protrusion is directly dependent on the size of the umbilical
rings – formations of a special shape surrounding the navel.

With a small ring size, the hernia only occasionally manifests itself in
time of strong crying or anxiety of the child. In the presence of a large
the size of the ring there is a constant swelling of the umbilical
areas that tend to increase visually during
crying and straining.

Hernia can significantly increase in size over a pair.
months. Diagnostics small hernias performed with
palpation – the doctor presses the baby’s navel so that the finger
slightly fell into the abdominal cavity. This method allows
reliably determine the exact size of the umbilical ring and detect
edges of the hernial ring.

A hernia rarely causes pain or discomfort to a child — it can
spontaneously appear and fall or be set off with the help
lightly pressing the hernial sac. If the defect is minor,
but it has hard edges – a child can be restless, long
cry, thus aggravating the pathological process.

Infringement of the contents of the umbilical hernia, especially in small
children, there is extremely rare. However, the hernia does not pass.
imperceptibly – such children are more restless, meteosensitive, and
are also more sensitive to any changes in
your surroundings. The hernia itself does not cause pain, but due to
increased gas formation provokes intestinal colic. Not treated
umbilical hernia is also a cosmetic defect, traumatic
psyche of the child.

Umbilical hernia treatment

Proper child development, restoration of intestinal function,
physical activity, follow the doctor’s recommendations
strengthen the abdominal wall of the child often lead to self-healing
hernia, and this probability is high for hernias up to one and a half
centimeters in diameter.

In most cases, revealed umbilical hernia in newborns
expectant treatment tactics are chosen. Spontaneous closing
small hernias (about 1.5 cm) occur by 3-5 years. If this is not
Happened, can be appointed surgical treatment. Basically
operations are performed at the age of 6 years, earlier surgical
relief is likely in the development of complications such as pinching of the hernia and
rapid progression of the pathological process.

Hernias larger than 1.5 cm in diameter rarely overgrow
on their own. In this case, it is possible to perform the operation earlier.
at the age of 3-4 years. Conservative treatment of umbilical hernia
at the same time it is the prevention of the development of this pathology and not
hurt any child:

  • Laying baby on belly

Daily, 10-15 minutes before the next feeding, it is recommended
spread the baby on the stomach, on a flat and hard enough
the surface is a table covered with a diaper, a changing table. This
the procedure can be carried out literally from the second week of life to 2-3
times a day. During the period in position on the tummy baby
reflexively muscles, which strengthens the tissues
umbilical ring. In addition, the muscles of the back and neck are strengthened,
intestinal peristalsis is activated and the process of natural
discharge of gases. While laying out should be next to
baby and not leave him alone.

  • Belly massage

Massage for umbilical hernia in a newborn can begin after
scarring of the umbilical wound. The main rule is not to overdo it,
avoid pressing and intense movements. Initially enough
make three or four gentle stroking movements with the palm of your hand
front of the baby’s tummy. Movements must be exclusively
soft, same in intensity. For older children
movements that train the rectus abdominis are added: the straight and
the index finger is placed 1-2 cm from the center of the navel
and make ten clicks with small and point movements. Then
they do the same by placing their fingers above and below the navel. Such
massage do 2-3 times daily before feeding, gently, not
causing discomfort to the child.

  • Imposing a defect on the adhesive bandage

A special adhesive bandage is applied medical.
employee for a ten-day period. Special overlay technique
dressings provides fixation of rectus abdominis muscles over the umbilical
ring. In the absence of effect from the primary application of the patch
the procedure is repeated two more times. There is an overlay technique
patch for umbilical hernia in a child without the formation of folds, with
mandatory replacement patch in 2-3 days. This method is more
soft, the patch can be changed by the parents themselves. This technique
permissible only in the absence of skin reactions and inflammatory
items.

  • General massage and highly specialized therapeutic exercise

This conservative treatment is carried out by massage therapists and exercise therapy doctors.
Treatment can be done already from one month of age. General massage
strengthens the child’s muscle corset, special exercises
train the abdominal muscles and strengthen the umbilical ring. With growth
child introduced new exercises. Repeat treatments
yourself should not, because you can harm your
to kid. Only a specialist individually selects
duration of activities, their load and the necessary multiplicity.

Surgery

Surgery грыжи проводят при наличии показаний –
large sizes of hernia, lack of therapeutic effect from
comprehensive conservative treatment for the first five years
life, dangers of infringement and infringement. Indications for
Umbilical hernia surgery in children:

  • The child has hernia complications, such as
    tissue infection or rupture
  • Child 5 years, but the hernia is not prolonged
  • Hernia growth progression after 6 months
  • The child is 2 years old, and the size of the hernia is more than 1.5 cm
  • The doctor is concerned about the appearance of the hernia

Parents are always afraid of surgery. but
This surgery is fairly straightforward.
performed quickly within 15-20 minutes and, as a rule, without
complications. During surgery, an umbilical defect
The ring is sutured. However, any surgeon making decisions about
need for surgical treatment, has good reasons for
this intervention itself. Untreated hernia with age
are transformed into a large hernial formation, prone to
abuses and regular relapses. Therefore, the question of the treatment of hernia,
including operational, should be closed before the start of training
at school.

Автор: врач-гигиенист, эпидемиолог

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