How to treat an inguinal hernia in children without surgery

The appearance of an inguinal hernia in a child occurs due to congenital disorders and acquired factors that served as the main cause of the disease in the first months of a baby's life. Parents often come to the pediatric surgeon when the hernia is already at an advanced stage and requires an urgent operation. Such an attitude towards congenital diseases is not the norm, and it is necessary to contact a specialist immediately after the first signs of pathology appear.

Treatment of inguinal hernia in children is carried out surgically, because at any time tissue infringement in the hernial sac can occur, which ends with the death of organs and the cessation of their functioning.

Various methods of non-surgical therapy are considered only as auxiliary when there are contraindications to surgery and the defect is small. In rare cases, a hernia in a child disappears on its own, but a relapse can occur at any time, and then the help of a surgeon will also be required.

Inguinal hernia in boys and girls has slightly different manifestations, and can result in complications of varying degrees of danger. If the child does not receive timely assistance, in the future this may become a factor in infertility and often recurring hernia.

Causes of a hernia in a child

The main factor in the appearance of an inguinal hernia in a child is the vaginal process, which is formed during the period of lowering the testicles and uterus from the abdominal cavity into the groin. This process will later become the area where organs exit into the inguinal canal. In girls, during the period of intrauterine formation, the uterus prolapses, which pulls the peritoneum behind it, forming a fold. It can protrude in the direction of the inguinal duct, and thus a hernial sac is formed.

Acquired hernia in children has a slightly different mechanism of development. Pathological protrusion occurs due to increased pressure in the abdominal cavity, and if this is combined with muscle weakness, a hole is formed that passes the organs into the inguinal canal.

How to identify an inguinal hernia

The following symptoms will indicate an inguinal hernia:

• swelling in the groin area - the formation is painless for the child, the rounded shape indicates an incomplete descent of the organs into the scrotum, in boys the testicle may also be enlarged, which already indicates an inguinal-scrotal hernia;
• an increase in the labia in girls is an external manifestation that is observed with an oblique hernia;
• reduction of formation in the prone position - when the child lies quietly on his back without crying and active movements, the swelling disappears, but returns again, and is clearly visible in a standing position;
• rumbling when the hernia is reduced - with light pressure on the protrusion, a characteristic sound is heard, which is a diagnostic sign;
• a symptom of a cough shock - during a sharp increase in pressure inside the abdominal cavity, the hernia sticks out.

A child has an inguinal, cord and inguinal-scrotal hernia, it can be unilateral and bilateral. The oblique form of the defect occurs only in boys and is characterized by the passage of organs around the spermatic cord. A direct hernia is diagnosed in everyone, while the protrusion passes through the weakened wall of the peritoneum, bypassing the inguinal canal. The combined form of the disease combines an oblique and direct type of hernia, which arose independently of each other.

Methods of treatment without surgery

To select the optimal treatment regimen, the child is assigned an ultrasound of the abdominal cavity and small pelvis. If the condition is not life-threatening and the function of the organs is not impaired, a planned operation is prescribed, and during the preparation, conservative therapy is performed, which combines several methods.

Uncomplicated inguinal hernia and its treatment without surgery in children require attention from parents and the attending physician. Regular examination by a specialist will be mandatory, because not all dangerous symptoms are visible externally, but they will be the reason for changing treatment tactics.

Conservative methods of treatment of a hernia in a child:

• strengthening the muscles of the abdominal wall - performing special exercises, swimming;
• wearing a bandage;
• relaxing abdominal massage;
• prevention of constipation and respiratory diseases.

Massage

Massage of the baby's tummy is performed before feeding. With a hernia, it will be enough to do light stroking and pinching of the skin, while not affecting the formation itself. During the massage, the child should be relaxed, in no case cry or feel discomfort. Before the procedure, it is recommended to warm up the tummy a little by applying a warm diaper or heating pad. The massage lasts about 5-7 minutes and ends with stroking the abdomen.

The technique must be selected with a doctor so as not to harm the child. Safe movements for a hernia will be a “water mill”, U-shaped and counter stroking.

 

During the massage, you do not need to lubricate your hands with special oil, it is better that they are dry and do not create strong friction. Movements are recommended to be performed clockwise, which will contribute to the normalization of peristalsis and the release of gases.

Bandage

An inguinal bandage for children with a hernia is an important measure for the prevention of complications. A special belt is especially effective for treating children under 5 years old, when the formation can still disappear on its own.

The goals of the inguinal bandage for a hernia in a child:

• prevention of protrusion of organs;
• fixation of a hernia without the risk of infringement;
• reduction of discomfort;
• distribution of pressure during straining and during crying.

The bandage is put on when the child lies quietly on his back. You need to fix it so that the special insert is placed directly in the area of ​​​​education and presses it somewhat, but does not squeeze it.

The bandage cannot cure a hernia, and its frequent use will only hurt, because it will be a temporary measure when there is a risk of complications.

Gymnastics

With children under one year old, it is not easy to set up the correct mode of physical activity, which will have a positive effect on muscle strengthening and hernia reduction, but some techniques will still help with this. It is important for parents to create conditions for active movement so that the child lies less and crawls more. Children need to be picked up more often, pumped from the tummy to the side and back.

With older children, you should do exercises daily, after putting on an inguinal bandage. It is also important to consult a doctor who will tell you what movements are undesirable for a child with a hernia in the groin.

Physical activity, unlike pills and a bandage, does not remove the symptoms, but helps to strengthen the muscles of the abdominal wall, that is, it fights the factor in the development of a hernia.

With babies, it is useful to do a warm-up daily with the permission of a doctor. For this, the child needs to be placed on their back on a hard surface and a number of exercises should be performed, including bending the knees, turning over to the side, and rotating the legs. The best option for classes with children would be specialized gymnastics under the supervision of an instructor.

Gymnastics is no less important after the removal of an inguinal hernia in a child. After a couple of months, together with a specialist, a set of exercises is selected that will help prevent the recurrence of the disease and will contribute to the normal physical development of the baby.

Indications and contraindications for surgery

It is possible to treat a hernia without surgery, but at any moment a complication can occur that will cost health and even life. Conservative techniques can prolong the uncomplicated course of a hernia in the groin area, when surgical treatment cannot be performed temporarily.

The following conditions are contraindications for surgery:

• congenital malformations of the cardiovascular system;
• discrepancy between height and weight;
• infectious diseases in the acute period.

The operation is prescribed urgently when there are complications. The absolute indication will be the infringement of the hernia. This condition threatens with the death of organs in the hernial sac, in boys the spermatic cord is damaged, in girls the fallopian tubes, uterus and ovaries are damaged, which causes infertility and chronic pathologies of the genitourinary system.

Complications

Such complications after the operation will be dangerous:

• bleeding and the formation of an extensive hematoma;
• lymphocele - accumulation of lymphatic fluid in the testicles;
• suppuration of the postoperative wound;
• severe pain syndrome;
• necrosis of the uterus, ovaries, fallopian tubes in girls;
• testicular atrophy with impaired function.

Prevention of complications

The recovery of babies after surgery usually occurs quickly, and if you follow all the prescribed preventive measures, rehabilitation eliminates any complications.

An important measure will be the diet, the following foods are removed from the diet:

• carbonated drinks and homemade milk;
• fatty meat and fish;
• cabbage, tomatoes, radishes, grapes;
• pastry with yeast, apples.

During the treatment of an inguinal hernia in a child without surgery, it is important to pay attention to the slightest changes in the condition, because they may indicate the addition of complications.

Alarm signals will be the causeless cry of the child, vomiting, tension in the abdominal cavity, swelling and redness in the area of ​​education, cyanosis of the skin. These conditions may indicate infringement, intestinal obstruction, peritonitis.

Squeezing in the hernial sac of the uterus in girls is a particularly dangerous consequence of a hernia, leading to the death of the organ within a few hours. Due to the high risk, it is necessary to treat a child only under the supervision of a surgeon, without ignoring the need for a planned operation.