A hernia, or as some people call it, a rupture, is a weakness in the wall of the abdomen. It allows intestines or other tissues from inside the abdomen to bulge through the weakened area. The two most frequent places for hernia in children are the bellybutton and the groin. Hernias may also occur at other places, including the diaphragm which separates the chest from the abdomen.
Some children are born with hernias due to a weakness located at the bellybutton, or in the groin where the thigh joins the abdomen. These hernias are thought to be caused by incomplete development of the child in his mother’s uterus. In other words, the child was born before he was completely finished.
A hernia in the bellybutton is called an umbilical hernia. It is recognized by the way the bellybutton bulges out, especially when an infant cries or strains. Beneath this bulge, one can sometimes feel a little opening in the muscle of the abdominal wall. Many umbilical hernias get smaller as the child grows during the first year of life, but other umbilical hernias stay the same size or grow larger. If an umbilical hernia is larger than a dime or nickel, and remains that way even after the child has passed his first birthday, it will probably not go away of its own accord.
Inguinal hernias, or hernias in the groin, can be very serious if a loop of intestine is caught in the hernial sac. Such hernias should always be repaired surgically. Hernias occur most frequently in the groin, because at this site there are gaps in the abdominal wall for blood vessels and the genital cord.
Doctors used to place a penny or dime in the opening of a hernia of the bellybutton, would strap it there with adhesive tape, and would leave it in place for several weeks at a time. They thought that this might make the hernia heal by itself. We now know that this doesn’t do much good. If an umbilical hernia is going to heal, it will heal even if we leave it alone.
An umbilical hernia can easily be cured by having a surgeon fix it. This is a simple operation, carried out in a hospital. It is not a painful operation because the child goes to sleep before it is performed. Afterward, there might be slight pain for a day or two, but it is not enough to keep the child in bed. Youngsters get out of bed the day after this type of surgery and they go home from the hospital a day or two later.
A hernia in the groin is called an inguinal hernia. Inguinal hernias are just as common as hernias of the bellybutton. When a hernia appears in one groin in a child under one or two years of age, there is a good chance he w develop a hernia in the other groin, too. Every once in a while an inguinal hernia will clear up by itself by the time a baby reaches the age of a year or a year and a half. However, most of them II do not clear up and have to be operate upon.
It is a good idea to operate on inguinal hernias, because there is a tendency for intestines to stick through the bulge of the hernia. When this hap-I pens, a child may get sick to his stomach and have pain in his abdomen. And, once in a while, a piece of intestine gets caught in the bulge of the hernia and doesn’t go back into the abdomen where it belongs. When this happens a child gets truly sick and must go to the hospital at once.
Most doctors recommend that inguinal hernias be repaired soon after they appear. If they appear at birth, they can be repaired when the child is a few weeks old. If they appear for the first time when a boy or girl is five or six years of age, they are repaired then.
The operation to cure an inguinal hernia is just as simple as the one to fix a hernia of the bellybutton. The child feels no pain during the surgery, as he goes to sleep beforehand. There is some discomfort in the groin for a day or two after the operation, but it doesn’t prevent the child from getting out of bed and walking around his hospital room. About two or three days after repairing an inguinal hernia, the child can go home.
After any operation for hernia, a child must take it easy for a few weeks so that the tissues heal solidly. This means that he may not be able to run and play, to roughhouse or to ride his bicycle for a few weeks. However, he can go back to school just two or three weeks after surgery. When the wound of the operation has healed solidly, he can do everything that he did before he was operated on. The bellybutton and the groin, after a hernia operation, are just as strong as they would have been if no hernia had existed.
Sometimes, in some hospitals, a mother may stay overnight with the child who goes in for a hernia operation. This depends upon the rules of the particular hospital to which the child goes.