Umbilical hernia in infants. Photos, symptoms and treatment, causes, clinical doctors' recommendations

Congenital or acquired hernial protrusion at the navel - a frequent phenomenon in the newborn baby. His stomach is a small annulus which tapers and is tightened. Not always, this process goes smoothly, but to correct the defect has arisen simply.

The structure of umbilical hernia

Umbilical hernia in infants which appeared within a period occurs in 1 out of 5 in the category of prematurity - each third.

The anatomical structure of protrusions is as follows:

• hernial ring in place of umbilical ring;
• bag as stretched parietal (wall) sheet peritoneum;
• fragments of the small intestine, sometimes the greater omentum was transferred to a bag.

Bulging umbilical localization are often barely noticeable, or the size of a pea, but sometimes they get a significant amount (up to the size of a plum), and the risk of infringement increases many times.

The reasons for the development of the newborn

No clearly traceable reasons, but the hereditary factors of umbilical hernia prevails over the other. Suffice it to 1 of the parents, who had at the same age protrusion that similar symptoms recurred in 70% of infants.

Other possible causes are the diseases complicated straining abdominal muscles and increasing pressure on the abdominal wall:

• SARS with hoarse cough;
• pneumonia;
• whooping cough;
• bronchitis;
• lactase deficiency with frequent defecation;
• goiter;
• dysentery;
• constipation;
• urinary problems due to narrowing of the foreskin in boys (phimosis).

Reducing the risk of celiac tone muscles have children:

• born prematurely;
• with a lack of thyroid hormone (hypothyroidism);
• protein and energy deficiency, which manifests poor digestion, exhaustion;
• with liquid accumulation in the abdomen (ascites);
• rickets;
• daunizm.

The failure of the abdominal wall tissue, musculoskeletal system may be due to unfavorable pregnancy because:

• viral infection;
• Polluted environment;
• hazardous work conditions;
• inappropriate dosage of medication.

anatomical features

Physicians hernia isolated embryonic and postnatal (after birth), because different anatomical and clinical characteristics. Omphalocele occurs in about 3.5 1 of th. embryos on the 3rd month.

This effectively depressurization abdominal cavity due to the combination of various factors:

• defects of the abdominal wall;
• anomalies of the ileum (Meckel's diverticulum);
• splitting the sternum;
• defects of the heart, the diaphragm;
• hypoplasia pubic symphysis (joint);
• clefts of the "cleft palate", "cleft lip";
• intestinal obstruction;
• displacement of the bladder due to the absence of the front wall;
• urahusa fragmentary cleft (urinary duct) to form cysts;
• partial or complete blindness (overgrowth) closure rectum prior to its entry into the anal cavity.

When embryonic defects in just born baby bowel loops, the liver appears through the transparent shell. Omphalocele fixed size of 5 to 10 cm or more.

When the newborn cries protrusion increases. During the passage through the birth canal, in the early hours of the birth of expanded umbilical cord may break and cause peritonitis, septicemia, pneumonia. Little chance of survival.

Postnatal umbilical hernia. It appears in the first year, especially in the first 2-3 months. Circular, oval protrusion at a voltage greater contoured abdomen, partially or completely drawn into the quiet supine. Shell it more durable, not translucent, may be slightly different in color from the rest of the skin.

Causes of long closure of the umbilical ring

Normally, after falling off the dried residue of the umbilical cord hole beneath it shrinks and fastsiruetsya (overgrown with special connective tissue).

Cause some delay fascia considered weak contraction of the upper half of the umbilical hole up from the bottom. The essence of the problem is that at the bottom there are 2 umbilical arteries and urachus. Nature has provided for this area a high density fabrics.

Coupling structure is first formed and then is transformed into fibrous that allows tightly close the lower section of the ring. The top is equipped with a 1 arc umbilical vein and that no shell, so here there is weakening.

Immature abdominal fascia closes the opening only partially, in place of insufficient density tissue formation defects, which arise from hernia.

Possibility to increase the pressure inside the peritoneum protrusions, prolonged disease negatively affecting the muscle tone, turgor (tension) tissues. If a normal full-term baby is not very active in digestion, bloating and constipation occur, it is hysterically crying, fibrous ring most of the time is squeezed out from the inside.

Naturally, in such circumstances, to pull together in time it fails. In infants, prematurely left the womb, all of these risks are increased many times.

It is believed that the hole is closed celiac reliably keeps the organs and even the duration of crying, crying will not be able to break it, as well as occasional violations of the chair.

Symptoms of an umbilical hernia

Umbilical hernia in infants is not always visible, but palpable. Convex protrusion easy to reduce a, if you put pressure on it with your finger. Because it has a loop of the small intestine, it feels a characteristic rumbling, gurgling sound. Exceptions are cases of infringement, but they are very rare in infancy.

How to determine the presence of umbilical hernia yourself?

The layman is difficult to reliably determine the pathology, if it is not evident. A considerable number of babies simply have a structure protruding navel without any unwanted symptoms.

Suspicion of parents on a hernia in the first few weeks or months of baby's life - it is an occasion to show it to the doctor. Let the fear will be false, than to miss pathology.

Diagnosis for medical conditions

Modern obstetric ultrasound machines capable of showing omphalocele still in the womb. Celiac hernia in newborn infant will determine pediatric surgeon or a pediatrician during a routine inspection. Expanded state of the fibrous ring is groping fingers.

In girls, in parallel with the identification of umbilical protrusion necessarily palpable inguinal folds. If you find a hernial sac with fallen ovary, most likely the surgeon will recommend surgical reduction. When celiac disease state protrusions or suspected problem held ultrasound differentiation.

If the doctor recommends hospitalization, he directs a series of tests:

• general analysis of blood;
• a blood test for hepatitis B, C and HIV;
• general urine;
• Biochemistry blood with determination of the total protein and protein fractions, total bilirubin, and fractions thereof, as well as indicators of urea, glucose, amylase, creatinine, potassium, sodium, chlorine, calcium, ALT, AST;
• coagulation (INR, APTT, thrombin time, prothrombin and fibrinogen);
• Study on helminth eggs (calories);
• ECG and echocardiography in the pathology and congenital heart defects.

Before the operation, mandatory counseling specialists indicated.

Do I need treatment for newborns umbilical hernia?

Neonatologists, pediatric surgeons, based on practical experience, it is believed that the protrusion at the navel area, in most cases disappear spontaneously with the strengthening of the abdominal muscles at the age of 6 months. up to 5 years.

This observation does not negate the surgeon - 1 time per month during the first year.

When they begin treatment and basic techniques

Umbilical hernia in infants quickly retracted when approximately 1 month., After the healing of wounds on the spot breakaway cord, will be correct conservative treatment:

• firming massage front abdominal wall hernia, with emphasis on the region;
• lying on his stomach;
• physiotherapy;
• swimming;
• gluing adhesive pad;
• wearing a bandage dressing.

Massage

It is better if conducted by an experienced massage malyutke spetsialis. Parents can also learn very simple massage techniques and perform it after otsyhaniya cord, complete healing of the wound. For procedures using the changing table, the laid a blanket layers, oilcloth diaper. The room should be ventilated. The desired air temperature - 18-22 °.

Clean warm hands with cropped nails and unadorned performed 3 different movements:

1. Gently press down on the bulge vpravimuyu thumb of 10-15 times.
2. Gently pinch the skin around the hernia sac.
3. Make a circular motion with his hand only in a clockwise direction, the thumb while utaplivaet bulge.

adult palm can anoint a little baby oil. Baby should be in a good mood. With him to talk, to sing. The massage is performed daily at the same time, half an hour before meals or 40 minutes. after. Length is increased gradually from 5 to 20 minutes.

If a patient starts to show a little anxiety, discontent, massage transferred to another time.

Placing your baby on his stomach

Grudnichka laid down on his stomach on a hard surface covered diaper. Start with 5 min., Since it is uncomfortable position, and the baby will protest. To tears bring it need not be, but you can not retreat. As habituation extend lying on the stomach for 20 minutes.

How to securely fenced in or was the child on the table, it is unacceptable to leave it unattended. You must make sure that he was not buried face down and not breathing currently blocked, get down on the floor. Children who are able to keep your head, let rest on the forearm, thigh widely bred for stability.

Putting down his stomach is the desire to get up, so not only strengthens the front of the celiac wall, but the whole muscular system. The best time for the procedure - 20 minutes. before each feeding to reduce colic from eating.

operative intervention

Hernia repair is carried over:

• infringement vybuhnuvshih bodies in the hernial sac;
• hernia growing and leading to digestive disorders, pain, colic due to hindered flatus and feces;
• not closed to 5 years in the fibrous ring.

In laparoscopic surgery is performed to reduce a loss. Through pinholes introduce surgical instruments and a mini-camera to reflect the operating activities of the monitor. bag itself is excised, reduce a dropped frames, gates sutured.

Low-impact intervention lasts about an hour, a few hours the child is under the supervision of doctors. After that, parents can take him home. In a growing body healing occurs quickly, scars are left.

If the infringement is carried out open cut, since it is necessary to remove peredavlenny bowel fragment. The excised intestinal tube ends are combined, then sutured to the abdominal wall biocompatible mesh that protects from re protrusions. Operation does not belong to the category of complex rehabilitation of short duration.

In both cases, the child should be put on the subsequent clinical account in order to avoid the rare cases when there are ligature (from sutures) or fistula recurrence of herniation occur and require repeated surgical intervention.

Traditional methods

Grandma and Grandpa's recipes apply only to reduce a hernia. Pediatricians and especially surgeons are skeptical about these methods, but inexplicably simple tricks in some cases turn out to be effective.

Compresses, lotions used once a day, only after healing of the navel.

recipe	curing time
Oatmeal	cook a thick porridge, cool and mold the cake a little more than the diameter of the protrusion	stick to 1-3 hours
Garlic	a little garlic masses must be wrapped in 2-3 layers of gauze, attached to bulge bandage, medical adhesive tape	if the child does not bake, you can leave for 2 hours
oak bark, fern	in a warm vegetable broth to moisten 3-4 layers of gauze to fix on the navel	up to 3 hours.
Cabbage pickle, raw potatoes	apply lotion with brine from sauerkraut second layer to exert a round potato slice; tie to wash does not move	5-6 hours.
white cabbage	washed, not a cold piece of cabbage leaf attach and fix	all night
Pig fat	good lard apply a thick layer on the problem areas, cover with a cotton circle and secure	from evening to morning
Clay	pure pharmaceutical powder is diluted with water, grease navel	before drying, after warm water soak, gently wipe
copper Soviet five-copeck coin	coin wash thoroughly, attach and secure	in the absence of stimulation - to 5 hours.

In parallel with the external means kids depending on age, give different restorative drink:

• Good month to drink birch juice of half a cup every day as a dessert.
• Broth hips infused for one hour, are not very concentrated, sweetened must be taken as 100 ml after 2-3 feedings.
• Gradually can give aqueous extract of ginseng root. It improves tissue metabolism, revitalizes the entire body.
• By quarter cup papaya juice after 4 feedings saturate vitamins, iron, folic acid. This juice - a good prevention of cough and useful supplement in curing it, which is important in abdominal hernias.

To treatment home remedies should be approached with caution. Domestic drug test in small doses, exterior - with a minimum contact time in order to avoid allergies, inflammatory processes. Will not be superfluous advice of pediatrician, surgeon.

jamming

Babies seldom suffer from infringement, but if it happened, symptoms may be as follows:

• hernia increases to reduce a longer changes its color;
• belly swells and hurts;
• nausea, vomiting;
• the skin turns pale.

trapping mechanism occurs in the following order: from sharp abdominal pressure gates are expanding, bag fills more, then compressed again annulus, peredavlivaya vybuhnuvshy fragment. Child urgently needs to deliver in a hospital, as increases intestinal obstruction, necrosis of the compressed tissue.

It so happens that there comes a brief relief of about 1-2 meters an hour from the time of crushing, but the delay is unacceptable, because it can break tense intestine, peritonitis, gangrene.

Prevention of umbilical hernia in newborn infants

Preventive measures include:

• breastfeeding on their needs, not by the hour;
• completion of all scheduled scans that identify a hernia;
• regular execution of gymnastic exercises with the help of their parents;
• preventive and restorative massage;
• early diagnosis and treatment of digestive pathologies.

Forecast

Umbilical hernia type omphalocele detected ultrasound, forcing the doctor to offer a woman an abortion because the fetus is likely to be other malformations. Postnatal bulging in infants who were treated conservatively or operatively, practically do not relapse and complications.

Clinical doctors' recommendations for parents

Pediatricians and pediatric surgeons emphasize to parents that after one year of age gradually increases the danger of umbilical hernias. Inadmissible hands folded just wait for the protrusion to the right spontaneously.

It is impossible to ignore visits to the pediatrician, and his recommendations:

• to keep breastfeeding as long as possible;
• for infants on artificial diet dry pick breast milk substitute, mixture of its corresponding most digestion;
• to monitor the regularity of the chair baby;
• nursing mother to use products that do not actively provoke flatulence and colic in children.

The specialized departments stores have a quality and proper nutrition for mothers on feeding period:

• bread products, bread, waffles;
• balanced baking the mixture;
• fruit and vegetable puree, mousses;
• breakfast cereals, muesli in suitable embodiments;
• juices, teas and other beverages.

preferred in domestic dishes:

• cereal porridges;
• vegetable stews, salads;
• boiled lean meat, fish;
• pasta from a good meal.

Umbilical hernia in patients with a high probability of newborns will be held to a year, if the massage attach swimming in pools or under the supervision of a physician and at home in the bath. Mothers who already have chosen a special adhesive tape to hold the bulge in the right position, it is necessary to bear in mind that this is a passive measure.

Much more effective than dynamic techniques - putting some baby on stomach exercises on a large fitness ball. Simple, is not tiring regular exercise will strengthen the celiac wall and the whole muscular frame, which will recover faster.

Protrusion of the navel in infants unnecessarily frighten parents. It is necessary to build a coherent scheme of recommended actions to implement it methodically and from the hernia will not go memories.

Registration of the article: Mila Friedan

Video of umbilical hernia in children

Causes, treatment and consequences of umbilical hernia in children: