umbilical hernia in infants
Introduction
Introduction to infantile umbilical hernia The detachment of the intestine from the umbilical ring is called umbilical hernia. Infant umbilical hernia is a congenital developmental deficient disease that gradually decreases with age. Most can heal themselves within 2 years of age. Epidemiology: Umbilical hernia is the most common form of umbilical disease. The incidence of infants is higher, especially in premature infants with low birth weight. As the age increases, the incidence gradually decreases. basic knowledge The proportion of illness: 0.021% Susceptible people: children Mode of infection: non-infectious Complications: intestinal obstruction peritonitis
Cause
Infant umbilical hernia
Increased intra-abdominal pressure (35%):
The umbilical scar is a congenital weakness after the baby's umbilical cord is detached, and the anterior and posterior sheath of the rectus abdominis in the infant is not closed in the umbilicus, leaving a defect, and the conditions for the formation of umbilical hernia are various causes of increased intra-abdominal pressure. Such as cough, diarrhea, excessive crying, etc., can promote the occurrence of umbilical hernia.
Anatomical factors (42%):
Infants, especially premature infants, low birth weight infants, malnourished children and children with cerebral dementia, have poor tissue development around the umbilicus or have a slower contraction and closure of the larger umbilical ring of the umbilical ring. Anatomical factors of umbilical hernia.
Prevention
Infant umbilical hernia prevention
Preventing the increase of abdominal pressure is an important measure to prevent the occurrence and development of umbilical hernia, such as strengthening the necessary care for the baby and reducing the crying of the baby; timing, quantitatively supplying drinking water, juice or vegetable juice to promote smooth bowel movement; To prevent respiratory infections, etc.
Complication
Infantile umbilical hernia complications Complications, intestinal obstruction, peritonitis
1. Adhesive adhesion: When it is stuck, it can cause pain in the umbilicus. Especially when the omentum is stuck in the sac, the pain is more obvious, and sometimes it can cause abdominal distension and vomiting.
2. Umbilical hernia incarceration: The contents of umbilical hernia are mostly small intestine, large omentum, etc., and incarceration rarely occurs. Once the umbilical hernia is incarcerated, various symptoms are intensified.
3. The umbilical hernia is worn out: the umbilical hernia sac and the cover are thin, and when there is an external force, it is easy to break through.
Symptom
Infants and children with umbilical hernia symptoms Common symptoms Navel wet abdominal coughing sputum flaming mother spot
It occurs in the babies several days and weeks after the umbilical cord falls off. At this time, the umbilical cord has an epithelium formed at the cut site. Therefore, the surface of the sputum has skin covering, mainly in the umbilicus where the tumor is prominent, and the mass is crying. Increased, the skin is very thin and slightly cyan, the tumor shrinks and disappears when lying quietly or sleeping, and there are loose wrinkles in the umbilicus. After the contents of the sputum are returned by fingers, the sound of water can be heard and can be touched. To the hard umbilical ring of the tissue, with your fingers deep into the umbilicus, you can estimate the diameter of the umbilical ring. When the child coughs, crying, the fingers can have a sense of impact when forced.
Examine
Infant umbilical hernia examination
1. The umbilical reversible mass is the most important clinical manifestation, especially when the baby is crying, and generally has no other symptoms. Shortly after birth, you can see a small round bulge in the umbilicus, small like a cherry, big like a walnut, small lumps can be loud and nervous when you are quiet or lying down. If you gently press it back with your hand, you can also hear a "beep" and feel a gas rushing back into your stomach from a small lump. Because the baby's abdominal wall and ankle ring are soft, incarceration is rare.
2. Generally only need to do abdominal X-ray film to understand the signs of intestinal obstruction.
Diagnosis
Diagnostic identification of infantile umbilical hernia
diagnosis
There is a reversible mass in the umbilicus, which is full when crying, and disappears when it is quiet.
Differential diagnosis
Generally, suffocation refers to the suffocation of the squirrels in the squirrels. It mainly means that the muscles at somewhere near the sacs are weak, so that the nearby small intestines are affected by the abdominal pressure and are squeezed into the sputum. If it happens to the male baby, it will even run into the scrotum, making the affected side of the sac and the scrotum appear particularly swollen in appearance.
Different place
The sputum of the sputum is more often than the umbilical hernia, such as abdominal pain, vomiting and other intestinal gastrointestinal congestion.
2. the same place
The timing of urgent surgery is when the small intestine is twisted or stuffed. At this time, local tenderness, swelling and abnormal color often occur.
