Umbilical and inguinal hernia

Hernias are also a common surgical problem in infancy and childhood. It is very common to see umbilical hernia than any other hernias in the body.

Umbilical hernia of children
The mother may notice an undue prominence at baby's navel, which becomes more noticeable each time baby cries, coughs or strains. This usually becomes obvious a few weeks after birth. This prominence is called an umbilical hernia. It results from a weakness of the tissues of the abdominal wall at the navel, which causes some of the contents inside the abdomen to get slightly pushed out from inside, giving  rise to a small lump. This lump can be easily pushed inside. Frequently the defect in the abdominal wall does not allow the introduction of the fingertip. Within months such umbilical hernias often close spontaneously.

In the course of an year or eighteen months, as the natural prominent belly becomes flattened, and when the abdominal muscles become strengthened as babies start to stand and walk, these defects close up and the hernia disappears. The practice of strapping the abdomen or tying a coin over the defect is not recommended. However, where the defect is large and admits the finger tip easily, chances are that surgical repair may be required, and this may be carried out once the baby has reached two years (or earlier if it is a big hernia). if the hernia causes pain, is red or inflamed, or is tense and cannot be pushed inside, or if there is any such doubt, consult a doctor urgently. Umbilical hernia, or a hernia on a side of the umbilicus, may occur in older persons. Sometimes the hernia is in the midline a few inches above the umbilicus; this is called a ventral hernia. These hernias need operative treatment.

Inguinal hernia
“Inguinal” refers to the groin. Due to a weakness of the muscles in the groin (either on one side or both sides) the contents of the abdominal cavity may get pushed from inside, resulting in a lump in the groin. This hernia is seen in males at all ages; infants, children or adults. It is commoner in adult males than children. There is a fullness on either one or both groins. This may be particularly noticeable on standing, crying, or coughing, and may disappear when lying down. If the hernia gets bigger, it usually goes into the scrotum as well; it is then called an inguinoscrotal hernia. Usually this lump can be reduced (i.e. push it back into the abdominal cavity). The treatment is surgical repair of the hernial orifice which is called herniotomy and mesh repair. A polypropylene mesh will be placed in the abdominal wall during the surgery to strengthen the abdominal wall. If there is pain over the hernia, it usually indicates that an obstruction has developed. If the hernia gets incarcerated(adhesion of the content of the hernia to the hernial sac) or obstructed immediate surgical attention is necessary. If the obstruction is not relieved the hernia can go on to the stage of strangulation (tightly compressed) where the blood supply to the contents inside the hernia gets cuts off and this becomes a surgical emergency.