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Managing hernia in children

Master John (not real name) had a swelling in the lower part of his abdomen. He was diagnosed with a hernia following a medical examination…

Master John (not real name) had a swelling in the lower part of his abdomen. He was diagnosed with a hernia following a medical examination when his mother took him to the hospital.

A surgical operation was carried out on him to correct the defect and had to spend days at the hospital.

A pediatric surgeon with the University of Benin Teaching Hospital (UBTH), Dr. Osasuyi Osagie, described hernia as an abnormal protrusion of a viscus (organ within the body) or part of a viscus through a defect in the wall of a cavity.

“This means if a particular organ is supposed to be in a particular position but that organ is going to another cavity that is not supposed to be, it is called hernia.”

He explained that some of the hernia cases in children include umbilical hernia, inguinal hernia, and that the commonest ones among them are inguinal hernia (hernia in the groin).

According to him, some  myths about hernia are the belief that it doesn’t happen in children; a particular  medicine can stop it as well as the belief that native medicine could cure it.

He said hernia is a defect and that it can only be treated surgically. He lamented that this wrong belief by parents always led to complications.

Symptoms

Dr Osagie said the symptoms of inguinal hernia include a swelling in the groin, which is the region between the thigh and the lower part of the abdomen.

He said though hernia is not the only cause of swelling in the groin, the special things about the groin hernia are that it swells when a child cries or strains and goes back inside.

“The growing will protrude as the child cries or strains, and when it stops, it goes back. It can get to a stage it doesn’t go back by itself and at that stage it is a more serious situation.

“Generally, the symptom of hernia is that there is a swelling that is straining, and it goes back by itself. If it swells up, it can get to the scrotum and goes back, but when it refuses to go back, it is heading towards complication.

“At that stage, it can become obstructed by blocking the intestines, thereby causing abdominal pains, vomiting among others. So generally, hernia usually swells up and goes back by itself. “

Risk factors

Dr. Osagie said the disease is usually congenital (birth defect ) especially in babies. “If it is common in a family, a child can have it.”

He said generally, the risk factor is when there is increased pressure on the abdomen, like lifting or carrying heavy items, particularly in adults.

Prevention

He said hernias that are congenital can’t be prevented but the child can be taken to the hospital to prevent complications.

“But those that occur, especially in adults as a result of pressure by lifting heavy items, it is just to reduce it but in children it can hardly be prevented.”

How it is diagnosed 

He said that in diagnosing the ailment, a doctor would examine the child when parents complain about swelling in the groin when the child is crying or coughing.

“We carry out the examination by pushing the swelling back depending on the region to know whether it is inguinal or umbilical hernia. That is the simple way it is diagnosed.”

He said ultrasound could also be used to diagnose it, but those that are trained doctors don’t need that to diagnose the ailment.

Treatment

The pediatric surgeon explained that the treatment is herniotomy by removing the defect in the groin and closing it.

“Medicine doesn’t cure it; it is a surgical thing, and only surgery can cure it.”

He advised parents to observe their children very well so as not to bring them to the hospital with complicated hernia (Obstructed hernia), as early presentation is key to treatment.