Umbilical hernia: unpleasant, but treatable

Umbilical hernia: unpleasant, but treatable
Children
Treatment in children
Newborns
Massage
In adults,
Symptoms
After childbirth
Pregnant
Older people
Treatment
Signs
How to identify
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How is an umbilical hernia in children

Omphalocele

A child with an intact hernia sac is stable and may not require special care before surgery. If there is a rupture of the bag, the treatment should be the same as in gastroschisis.

Receipt of intravenous fluids should be maintained, and the bag must be covered with non-stick grid.

Move the contents of the abdomen and surgical closure is usually achieved as a result is not very difficult operation, with a small or moderate amount of the bag. Cases with a large omphalocele, including liver, heavier.

Gastroschisis

Scheduled deliveries ahead of time can improve the effects of the operation. Some patients may initially be carried plastic closure (suturing the abdominal wall with a gradual decompression). In most cases, the main goal is primary closure of the defect. But it should be postponed if the intestines are too inflamed and enlarged. The closure should not be too tight, it can lead to respiratory and cardiac problems.

The child may require stabilization prior to surgery. Respiratory stress may require decompression of the stomach and sometimes intubation. You can compensate for the loss of fluid intravenously. The child should be placed under an electric fireplace to avoid heat loss. Should be used broad spectrum antibiotics to avoid infection. Parenteral nutrition should be carried out through a central vein catheter should be set to determine the amount of urine, and it is necessary to conduct a survey for the expansion of the rectum. Bag gastroschisis require temporary protection in a special tank.

Complications

Omphalocele may violate the nitrogen balance and lead to growth disorders. It is also possible poor absorption power. Increased liver and bile stasis may be the result of prolonged parenteral nutrition.

High probability of sepsis, if the power is poorly absorbed, which may be further complicated by respiratory failure due to increased intrathoracic pressure. According to the studies, patients with gastroschisis enteric pathogenic bacteria detected. About 20% of patients develop sepsis.

Major fetal umbilical hernia may require several operations to correct the defect. Liver injury can be a late complication.

The main complication of gastroschisis is intestinal atresia, which occurs in 10-20% of patients. Violation of absorbing too common.

After surgery, intestinal dysfunction may last for several weeks and may require further parenteral nutrition. Too tight closure of the defect can lead to breathing problems, heart and blood supply to the kidneys.

Significant loss of viable bowel can lead to short gut syndrome.

Forecasts

The forecast for both states has improved significantly over the last 35 years, thanks to the improvement of parenteral nutrition and mechanical ventilation. Especially in gastroschisis these improvements have led to an increase in primary closure, which reduced the number of complications of surgery, such as sepsis. In both cases, the survival rate is now greater than 90%.

But still a significant mortality. In both cases, increase the likelihood of fatal liver movement in the bag, and intrauterine growth restriction.

Omphalocele. The prognosis depends on the size of the defect, the presence of chromosomal abnormalities and other complications such as sepsis or pulmonary dysfunction. Despite the progress, there are mortality and morbidity. The mortality rate in patients with uncomplicated omphalocele about 10%, but it could rise to 100% in the presence of other serious defects.
Gastroschisis. The mortality rate before surgery was 17%. Most deaths occur in sepsis, premature labor Premature birth - Recognize the signals of the body in time or bowel infarction. Postoperative survival rate of 87-100%, although it takes a long hospital stay. Poor prognosis is more likely complications, zatragivyuschih intestines, such as necrosis, atresia, expansion or thickening of the bowel, or the complexity of the closure of the defect.

The presence of other birth defects increases morbidity. One study showed that a third of patients suffer from stunting. Thus neurodevelopmental delays were not.