Hernias in a child Flashcards
What is a hernia?
Protrusion of internal contents through the wall of the cavity that normally contains it
What is an indirect inguinal hernia?
Hernia goes through inguinal canal superior and medial to the pubic tubercle.
Due to a failure of process vagialis to close
At which age is indirect inguinal hernia at most risk of strangulation?
First few months of life
- needs immediate repair
How to manage inguinal hernia in neonates?
Surgical repair 1st line
If reducible : manual reduction and elective surgery
If incarcerated : emergency manual reduction of hernia contents under IV morphine
What are the guidelines for surgical correction of inguinal hernia for different ages of children
<6weeks = within 2 days
<6months = within 2 weeks
<6years = within 2 months
What is an umbilical hernia?
Under the umbilicus. Common in newborns and often resolve by 12m.
Risk factors for umbilical hernia?
afro-carribean, down’s syndrome,
Management of umbilical hernia?
<1yo = watch and wait
small <1.5cm or asymptomatic = observe until age 4-5
large >1.5cm or symptomatic = elective repair at 2-3 years
Incarceration of umbilical hernia?
manual reduction and surgical repair within 24 hours
What is an umbilical granuloma?
Wet moist and leaking fluid
Requires salt treatment but is common in first few weeks of life
Signs of hernia strangulation?
Severe abdominal pain
Vomiting
Signs of bowel obstruction
What surgery is done for strangulated hernia?
Emergency herniotomy
What is a differential for indirect inguinal hernia?
Hydrocele
The tunical vaginalis is affected
Symptoms of a hydrocele
Transilluminated
able to get above swelling on palpation (CAN’T GET ABOVE SWELLING = HERNIA > HYDROCELE).
How to manage hydrocele
review at 1 year of age with consideration of surgical repair (usually resolve within first few months of life).
