How to tell it is a hernia
May 14, 2013
As Patience’s baby grew, so did the bulge around his bellybutton. A doctor diagnosed him with a hernia, but said it was nothing to worry about. “He said sometimes the condition corrects on its own, but if it persists, surgery is done,” Patience says.
By Hope Sande
As Patience’s baby grew, so did the bulge around his bellybutton. A doctor diagnosed him with a hernia, but said it was nothing to worry about. “He said sometimes the condition corrects on its own, but if it persists, surgery is done,” Patience says.
What is hernia?
Dr. Sabrina Kitaka, the president of the Uganda Paediatrician’s Association, says a hernia occurs when a section of the intestines protrudes through weak abdominal muscles. “A soft bulge usually develops underneath the skin, at the hernia site. It mostly occurs around the bellybutton (umbilical hernia) or in the groin area (inguinal hernias).
Types of hernia
Childhood hernias can be classified as incarcerated or strangulated. Incarcerated hernias occur when the organs or tissues become trapped in the muscle opening, while strangulated hernias come about when blood supply is cut off from the organs or tissues.
Causes
A hernia that occurs in the genital area mostly affects boys, and that is why doctors insist that boys have testicular exams.
Inguinal hernia
As the foetus grows and matures during pregnancy, the testicles develop in the abdomen and descend into the scrotum through the inguinal canal (a passage that allows structures from the abdomen to pass into the genital region).
After birth, the canal closes off, preventing the testicles from moving into the abdomen, but if the area does not close completely, a loop of the intestine moves into the canal through a weakened muscle, causing a hernia.
Umbilical hernia
Umbilical hernia may develop a few months after birth, resulting from a weakness in the abdominal muscles. At birth the umbilical cord (a passage that connects the mother to the baby) is cut off and the opening closes as the baby matures. However,a loop of the intestine may dislodge in the opening, resulting in a hernia.
Who is at risk?
Children at risk include those with abnormalities in the urethra, those with undescended testes and premature babies.
Signs
Hernia can be seen and felt. It may be noticed several weeks or months after birth, but will become more visible with increased pressure on the abdomen. For instance, when a baby cries, a bulge may appear in the scrotum or belly-button area, and retract when they baby relaxes.
If the hernia continues to bulge, this may imply that the loop of the intestine may have been trapped in the weakened area of the abdominal muscles. This may result in; vomiting, pain, redness, fever and a protruding abdomen.
Diagnosis
A doctor carries out a physical examination and may push back the hernia, or will recommend an abdominal x-ray, or ultrasound scan to examine the intestines closely, especially if the hernia continues to bulge.
Treatment
Daniel Tumwine, a paediatrician at Mulago Hospital, says treatment depends on the child’s age, overall health, medical history, the type of hernia and whether it is reducible or not.
Groin hernias require surgery and it is done under general anaesthesia.
Surgery is not recommended in newborns and is usually done when a child is two to three months old to ensure that the lungs are fully functional. Surgery is carried out.
With umbilical hernia, many times the condition corrects on its own, but in case it persists by age of three, a child may be operated on.
Tumwine says most children who undergo hernia repairs are usually discharged the same day of the operation. However, premature infants may require an overnight stay for monitoring.
A child may recover in a few days and can resume normal activities thereafter.
In cases where an inguinal hernia extends downwards into the scrotum, it may swell after even after surgery, but according to Tumwine, this should not cause alarm because the swelling subsides on its own, several weeks or months later.