Treatment of inguinal hernia in children

In general, there are two main strategies of all inguinal hernias Inguinal hernia - dangerous or not?   in both children and adults: observation and surgery. Observation is obviously not a cure in the truest sense of the word, but the doctor may prefer it if the hernia is small, does not cause significant discomfort, and if it can be pushed into the abdominal cavity. Strangulated hernia and hernia of large size is usually recommended once treated surgically. However, sooner or later, an operation necessary in any case, as an inguinal hernia will not go away by itself.

Many parents are afraid of surgery inguinal hernia in infants and older children, but in fact it is better to carry out before the wait for the infringement of a hernia or develop other complications. If the operation is carried out in a timely manner, the risk of complications is minimal, and the child will only have a small scar. In addition, the risk of relapse in the treatment of uncomplicated inguinal hernia in children is very small - it amounts to less than 1%.

Right-hand and left-sided inguinal hernia Inguinal hernia - dangerous or not?   in children are associated with a low risk of postoperative hernia on the opposite side. In such cases, the surgeon may offer during the operation to carry out strengthening the abdominal wall on both sides to reduce the likelihood of re-herniation. The obvious advantages of this treatment lies in the fact that the child in the event of a relapse will not have to endure another surgery, and again exposed to general anesthesia. But there are also disadvantages: firstly, the likelihood of another hernia after treatment unilateral hernia is quite small, and secondly, there is a small risk of damage to the testicles and the vas deferens during the operation.

When to carry out the operation

The answer to this question depends on the child's age, overall health, as well as on the type of hernia. If found inguinal hernia in an infant Baby man, though with a little finger , Surgery is recommended as soon as possible and, in general, the younger the child, the usually lasts less than observation of the patient. When inguinal hernias in older children and adolescents, do not cause severe symptoms, your doctor may temporarily postpone the operation. When diagnosed

inguinal hernia in premature infants, the treatment may also be delayed until the child attains a certain weight and get stronger - then the operation will be more secure. However, in the case of infringement of any inguinal hernia patient requires urgent surgery.

Types of surgery

There are two main types of surgical treatment for inguinal hernia:

• Open surgery to remove an inguinal hernia in children

This operation is carried out through a long incision in the groin .  If the hernia protrudes through the abdominal wall, it is pushed back, and if it has fallen on the inguinal canal, in some cases it is necessary to remove .  Weakened areas of the abdominal wall is traditionally firm, stitching together the edges of healthy muscle tissue (this operation is called herniorrhaphy) .  This method is suitable for small hernias present from birth, and also in cases when there are openings in the abdominal wall is healthy tissue, and seams will not result in undue pressure on it .  When treating large hernias and also in the case of recurrence, in order to make certain parts of the abdominal wall stronger, the surgeon may use a grid of special synthetic material .  This grid serves as a patch that is sewn on the weak, insufficiently dense regions of the abdominal wall after the surgeon reduce a hernia - this operation is called a hernia repair .  This reduces the load on these parts, and reduces the risk of recurrent herniation .

Removal of inguinal hernia in children can cause complications such as swelling in the area of ​​the scar, slight or moderate pain. Within a few days the child because it may be more moody than usual. If after the operation there are such signs as redness of the skin around the scar, swelling tekstikul, fever, and if through the bandage on the seam starts to leak blood, you should immediately consult your doctor.

In most cases, open surgery to remove an inguinal hernia is completely safe for children. The probability of relapse ranges from 1 to 10 to 1 to 100 - depending on whether a child sided hernia and whether hernia repair.

The main risk associated with the open surgery to remove a hernia Removal of inguinal hernia - all features of the procedure Is a reaction to general anesthesia. There is also a slight chance of nerve damage, loss of sensitivity of some areas of the skin, circulatory disorders of the scrotum or testicles, and, as a consequence, testicular atrophy (very rare complication), damage to arteries or veins.

• Laparoscopy

Laparoscopy inguinal hernia in children is rare, for example, a bilateral hernia. It is very similar to other laparoscopic procedures. Laparoscopy is performed under general anesthesia through a small incision that do just below the navel. Through them into the abdominal cavity pump air surgeon to better view the internal organs. In one incision a laparoscope is introduced, which allows to obtain an image of the abdominal and groin inside. Tools for surgery are introduced through the other incisions, and with their help, guided by an image that is displayed on the monitor, the doctor conducts herniorrhaphy and, if necessary, hernia repair.

Recovery from laparoscopy usually lasts less than after open surgery - an average of four weeks. The probability of relapse after this procedure is slightly higher, but it is less likely to cause serious complications. In general, the treatment of inguinal hernia any surgical methods are very safe and rarely lead to serious health consequences.

Early diagnosis of autism

The sooner the symptoms of autism are detected, the more effective will be its treatment On this basis, the National Institute of Child Health and Human Development recommends that parents consult a doctor to check the health of their children when they do not meet the following development indicators:

• At the age of 6 months, the child does not smile and do not express the joy and pleasure.
• At age 9 months, does not react in response to a smile, and mimics the sounds similarly.
• At the age of 12 months does not respond to his name.
• At the age of 12 months have not started sputter and coo.
• At the age of 12 months gestures without looking around and waving his arms.
• By 16 months, the child did not say a word.
• To 2 years does not say two-word phrases.
• Loses verbal skills and social skills at any age.

If a child has found at least one of these deviations, the parents are not in any way have to stick to wait. Such violations can talk about autism, if not, what about health problems. Early diagnosis and prompt treatment are essential to achieve long-term results in the treatment of disorders in the development of any kind, including autism.

The first signs of autism in young children look like a lack of normal behavioral responses rather than as a non-default behavior, which is why its so hard to find. Sometimes the symptoms of autism are interpreted incorrectly as signs of "obedient child" as the baby seems calm, independent and undemanding. But if you know what to look for, you can identify the earliest warning signs.

Some kids with autism do not respond to a hug, do not ask to take them in his hands and did not look at his mother during feeding.

The first signs of autism in infants and toddlers:

• Do not look into the eyes (eg during feeding).
• Do not smiling in response to the smiles of others.
• Do not respond to his name or the sound of a familiar voice.
• Not accompanies objects eyes.
• Do not point the finger, do not wave goodbye and do not use other gestures to communicate.
• Do not the eyes of the gestures of others.
• She does not speak or shout to attract attention.
• Not trying to embrace or respond to a hug.
• Do not repeat the movements and facial expressions of others.
• Do not ask for arms.
• Do not play with other people, do not share the interests and happiness of others.
• He does not ask anything about what the children are usually asked. Do not asked to help him.

If completely healthy child or young person for a day or two behaves strange or unusual, it may mean that he got sick, not feeling well, tired or under stress How to beat stress? Create an oasis . But if a child is always present some of these symptoms, or the symptoms persist for a long period of time, you should consult a doctor, pediatrician or another specialist. Typically, autism is diagnosed at the age of 4-6 years, although at the age of 18 months, some parents begin to suspect that their child that something is wrong, and when the child turns two years, discuss their suspicions with the doctor.

Here are examples of behaviors for which it is recommended to see a doctor:

• The child withdraws into himself and pays no attention to the world around us.
• No one is playing and not talking.
• He is trying not to communicate with others.
• Poor speaks poorly understood speech of others.
• Shows uncontrolled outbursts of anger.
• Insist on compliance with the established order and uniformity of action.
• The tendency to implement repetitive compulsive actions.

There is no such X-rays or laboratory tests that would confirm the diagnosis of "autism." Diagnosis of the disease is based on clinical evaluation, which is carried out by observing the behavior of the patient. Information from members of his family and other people around at diagnosis is of paramount importance. Also pediatrician can conduct tests to help rule out possible diseases with symptoms similar to the symptoms of autism. This disorder such as mental retardation, metabolic disorders Metabolism: The basis of life of all living things   and genetic disease or deafness.

One visit to the pediatrician is not sufficient for the diagnosis of "autism."

• Examines the child to the pediatrician, who may be a screening test to determine whether there is a developmental disorder. By themselves, the screening tests can not detect the presence of autism. They are conducted in a clinical setting and can help determine whether there is any problem. Usually they are a simple observation of certain behaviors (for very small children) or the reaction of the child to simple directions and questions (in older children). The most common screening tests include the questionnaire to identify autism (CHAT) in children aged 18 months to 4 years, as well as the Screening Questionnaire for identifying autism in children Autism in children: the warning signs   ages 4 years and older.
• Before you begin treatment, you must eliminate all other possible diseases and confidently diagnose autism.
• If the pediatrician thinks that for the diagnosis of the disease is necessary to carry out additional tests, it sends a child to a specialist who deals with disorders associated with the development. This can be a pediatrician involved in the development of the child, a child psychiatrist, child neurologist or child psychologist.
• In the process of diagnosis may also involve other experts, such as experts are concerned with the development of language skills, audiology (hearing problems specialists), medical occupational therapists, physiotherapists and social workers.

Comparative evaluation of a child with autism include:

• Analysis of the patient's medical record and family history
• An objective examination
• Objective audiological examination
• Diagnostic tests / laboratory studies selected for each patient (for example, tests to determine the levels of lead, genetic testing, metabolic tests, magnetic resonance imaging of the brain, electroencephalogram (EEG)).
• Evaluation of speech, language and communication skills
• The rating on the cognitive and behavioral level (the focus is on assessing the skills of communication and interaction with others, problem behaviors, motivation and retention of skills, sensory perception, and self-control), as well as evaluation skills in the educational level.