CONGENITAL HERNIA clinical features .pptx

A congenital hernia is a defect present at birth where an internal organ or tissue protrudes through an abnormal opening in the muscle or wall that normally contains it. It occurs due to incomplete development of the diaphragm, abdominal wall, or other structures during fetal growth.

1. CONGENITAL HERNIA & HYDROCELE DR JAGDISH MUTREJA

2. Congenital inguinal hernia Inguinal hernia repair – one of the most common surgical procedures in paediatric pts Incidence – 3-5% in term & 9-11% in preterm infants Boys >girls ( 6 times ) 60 % inguinal hernia R side , 30% -- L side, 10% r B/L

3. Processus vaginalis – elongated diverticulum of peritoneum It accompanies the testicle on its descent into the scrotum It generally obliterates by 9 mth of gestation or soon after birth

4. Variable persistence of PV –scrotal hernia with protrusion of intestine , ovaries, or communicating hydrocele All communicating hydrocele r repaired in same manner as inguinal hernia

5. SYMPTOMS When child cries there is globular structure appears in inguinoscrotal region When he lies down the swelling disappears completely Sometime wen the child jolts the swelling appears again

6. Diagnosis Clinical history & examination Communicating hydrocele can be difficult to reduce at times Transillumination test may be positive to distinguish cong hydrocele from hernia Palpation of thickened cord as compared to C/L side – confirm the diagnosis

7. D/D Congenital hernia Congenital hydrocele Epidydmitis Testicular torsion Torsion of testicular appendage UDT

8. Major risk of inguinal hernia – bowel incarceration with potential strangulation

9. Treatment Early surgical repair in premature infant Do surgery in mature infant till one yr Pts wit incarcerated hernia – attempts made to reduce hernia After reduction hernia repair done after 24- 48hrs wen the edema subsides Rx is herniotomy

10. Umbilical hernia Tendency to close in 80% cases Elective repair done after 5 yrs of age History of incarceration- prompt surgical repair Large umbilical hernia fascial defect > 2cm – early surgical repair

11. SUMMARY Congenital Inguinal hernia – common peads operation Diagnosed on history & clinical exam Surgery for cong. hydrocele & hernia – herniotomy at one yr age Umbilical hernia repair – 5 yrs No mesh is used in children