Архив рубрики «Пупочная грыжа симптомы»
The insidious thing medical statistics.Operating with huge numbers, it reluctantly, or intentionally contributing to reduced attention to the essence of the facts behind these figures.
A striking example is the situation with the infant and child herniated stomach.Medical world is already accustomed to and calmly states that inguinal hernias occur more than 5% of children, with preterm infants, they found 3-5 times more likely than full-term, and boys with this disease, in 3-10 more than girls.
With infantile umbilical hernia is worse. For the same medical statistics, these hernias occur in every fifth child, and every third premature baby. But in general the umbilical ring defects are detected in almost all newborns.
Of course, the identification of this disease a major concern of parents and pediatricians do not remove the assurance that, given the etiology of umbilical hernia in the absence of complications, usually calm,that with the development of the musculoskeletal system for the majority of children, infant umbilical hernia samoizlechivaetsya to 1.3 years,as happens in the preschool years.
This situation naturally requires the awareness of parents about the etiology of infant umbilical hernia and affordable preventive and curative measures. Science that deals with the study of various hernias called celology (from the Latin hernia — hernia and the Greek logos — the doctrine).
What is an umbilical hernia?
Let’s start with the definition of the disease.
In general, the hernia — a protrusion of internal organs from the cavity in which they are located, through defects in the wall of this cavity. Umbilical hernia — a protrusion through the umbilical ring (navel) of the contents of the abdomen.
Umbilical ring in the center of the white line belly «- the band consisting of ligaments, not muscle, passing in the middle of the abdomen. This band is easily detected, particularly for men with athletic build.Umbilical ring — the hole through which the fetus is connected to umbilical cord (umbilical cord), which contains, inter alia, various vessels, with the mother’s body.
After birth, the umbilical cord ligated, her balance is eliminated.At any time after the vessels of umbilical cord falls off, tightened connective tissue spanning the opening of umbilical ring, which closes and scars. Strengthen and tightening the ring as the abdominal muscles.It is clear that to fill the umbilical vessels and strengthening the abdominal muscles need time.
Immediately after birth, the umbilical ring is weak, nezarosshee, as well as the rectus abdominis muscle, forming a hollow ring, located at a distance from each other in the event of an increase in abdominal pressure can protrude through the ring of the greater omentum, peritoneum, and even bowel loops.This is the umbilical hernia, it can be felt, she felt under the skin like a soft balloon.
With increased intra-uterine pressure (by jeep, difficulty defecating, with a very prolonged crying) through the translucent shell may even be visible gland, intestines, internal organs of the baby. After reducing the pressure swollen abdomen, intestines back in place.
Manifestations of umbilical hernia in children
Umbilicus in healthy babies slightly protruding above the belly and resembles a rosebud, a child with a hernia appears noticeably further.With a small amount of holes umbilical ring belly button sticks out over the tummy for about 0.5 cm, and the ring is closed more often for several weeks. With a large diameter umbilical ring navel will rise by 1 cm or more, and the hole will be closed for months.Dimensions umbilical hernia may be from a pea to a pear.
With a diameter of the umbilical ring to 1,5 cm defect closes itself, usually to 3-5 years. According to medical statistics, 99% of patients with infantile umbilical hernia recover on their own.
But if after the execution of two years of a child’s umbilical hernia is still growing may become necessary surgery. Also, when a large diameter umbilical ring (more than 2 cm) to rely on self-closing it is unrealistic and should operate, possibly at the age of 3 — 4 years.Furthermore, if the umbilical hernia has not closed to 5.7 years, needs an operation.
If the hernia is causing your child discomfort, a concern, there is a risk of complications, surgery can be performed even as early as 3-6 months.If the child is already out of infancy, the operation can be performed at any time when the baby is healthy. Umbilical ring to close prior to sending your child to school.With age, decreased tissue elasticity, and not a closed umbilical ring in childhood can become an adult in a large umbilical hernia.
The absence of prejudice, pain, light vpravlyaemost umbilical hernia in a child is no reason to not treat it.Treachery of the disease is not eradicated in childhood hernia in adulthood can be a serious problem.
The longer hernia exists, the greater the odds hernial more of the internal organs are displaced relative to each other and disrupted their work and laxation, and food and stool can not move normally.Typically, adult umbilical hernia fraught with frequent relapses, and infringements. In children, their treatment is much easier than adults, and the whole world is trying to cure a hernia anterior abdominal wall is in childhood, preferably pre-school.
In adults, abdominal wall hernia developed by reducing the elasticity of the aponeurosis (connective tissue in the abdominal wall) and increase in abdominal pressure (physical activity, coughing, difficulty urinating, constipation, etc.).They develop, usually in a «weak» areas — groin and umbilical area, the middle line of abdomen, etc.
Patients worried about the appearance of the elastic protrusion in the above areas, which increases when you cough or physical exertion, and may disappear completely at rest, especially in the supine position.The danger lies in the possibility of prejudice to the contents of the hernial sac at any time (colon, omentum, bladder, etc.), with the development of necrosis of entrapment, acute intestinal obstruction, peritonitis. Therefore, hernia of any location, at any age requires surgical treatment.
Before the 70-ies, the main type of surgical treatment for hernias of the abdominal wall was tense hernioplasty (cross-linking, impaired contraction of the edges of the aponeurosis to form a more dublication).As a result, after surgery, the patient experienced intense pain when moving within 2-3 months, and had to wait at least six months, until a dense scar in the place sewn edges of the aponeurosis. Only after that the patient was allowed to actively move and exercise.Number of relapses (re-emergence of a hernia at this point) was more than 10%. This was due to the fact that the aponeurosis in this situation behaves like an old sock — patched in one place, weakens and breaks out nearby.
30 years ago there were synthetic mesh implantatnty (in appearance resemble the lace curtains on the windows), and gradually began to develop methods of relaxed hernioplasty.Its essence is to eliminate the hernia in the first stage, and then instead of joining the edges of the aponeurosis, the place of the defect, the thickness of the tissue with a margin around the edges, set mesh implant, which is fixed to the aponeurosis.As a result — there is no strong and prolonged pain (no tension), no 6 month wait for the formation of scar (implant withstand a load of 5 tons), the number of relapses decreased by 10 times and is less than 1%.
15 years ago, laparoscopic access was used extensively in the treatment of abdominal wall hernias.This method collected all the positive qualities of laparoscopy (minimal invasion, rapid rehabilitation, an excellent cosmetic effect) and relaxed hernioplasty using synthetic implants (no pain, rapid return to active life, reducing the number of relapses).
About the transactions you can read articles and watch videos:
Medical newspaper. Chicago Congress of Surgeons
The National Radio Company of Uzbekistan. News. Master class, KV Puchkov
Medical Newspaper. A meeting place for the traditional
Modern synthetic implants are completely inert and does not come into contact with body tissues, allowing their use in various fields of surgery, gynecology and urology.Particularly effective in laparoscopic procedures for hernia localization of multiple and recurrent hernias after open surgery. In these situations, there are practically no own tissues, needed for plastics (closing) of the hernial ring.Also, laparoscopic access is indispensable in conjunction with other diseases of hernia of the abdomen and pelvis, which require surgical treatment.
I have the experience of more than 600 surgeries using mesh implants, both open and laparoscopic methods.The results of my work are summarized in the monograph — «The use of synthetic polypropylene implants in surgery, urology and gynecology.
Surgical treatment of hernia of the abdominal wall — a very individual process.There can be no single standard approach to treatment, so the choice of open or laparoscopic technique using mesh implants should only be necessary to consult when viewed from the patient.
After laparoscopic surgery on the abdomen skin incision length are 3 to 5 mm.Patients with a first day start to get out of bed, drink and take liquid food, and the third — to eat normally. Discharge from the hospital carried out on 1 — Day 6, depending on the size and location of the hernia. On the paper the patient may begin within 7 — 20 days.
New!In my practice, I began using the grid of the latest generation of special weaving ability of one party is firmly fixed to the tissues of the abdominal wall.By using this implant is not a need to further lock it to the edges of the aponeurosis with titanium clips, which further reduces the risk of intraoperative complications.