Ventral Hernia In Children

What is a ventral hernia?

• A ventral hernia is a bulge through a hole in the wall of your child's abdomen muscles. The bulge may be caused by tissue, fat, or an organ such as your child's bowels. Two common types of ventral hernias that occur in children are epigastric and spigelian. An epigastric hernia usually occurs above your child's bellybutton. With an epigastric hernia, your child's caregiver may push the hernia back into your child's abdomen. If fat or bowel is stuck in the hernia, it cannot be pushed back and surgery may be needed. If some of the tissue inside of the hernia starts to die, surgery is usually needed right away.
  
  
• A spigelian hernia is rare in children but may occur on one side of your child's lower abdomen. With a spigelian hernia, part of your child's bowels may be inside of his hernia. Spigelian hernias are usually treated with surgery. With treatment, your child's hernia may no longer bulge through his abdomen muscles. It may be easier for him to have a bowel movement (BM). Treatment may decrease his pain. It may also help prevent your child's hernia from getting bigger and his bowel from getting twisted.

What causes a ventral hernia?

Your child may be born with weak muscles in his abdomen. This may happen if his abdomen muscles did not completely develop before birth. Your child may be born with a hernia or may develop it later.

What are the signs and symptoms of a ventral hernia?

Your child may have any of the following:

• A bulge on his abdomen.
  
  
• Swelling in his abdomen.
  
  
• A purple or blue mark on his abdomen.
  
  
• Redness near his bellybutton.
  
  
• Nausea (sick to his stomach) and vomiting (throwing up).
  
  
• Pain in your child's abdomen that may get worse when crying or having a BM.
  
  
• Blood in your child’s stool.
  
  
• Constipation (dry, hard stools).

How is a ventral hernia diagnosed?

Your child's caregiver will look and feel for a bulge in your child's abdomen. Your child’s caregiver will ask about your child’s past medical conditions. He may also give your child blood tests to help see if your child's hernia is infected from germs called bacteria. Your child may also need any of the following tests:

• Computerized tomography scan: This is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your child's body. A CT scan may help your child's caregiver see if your child has a ventral hernia. His caregiver may also see the size of your child's hernia and what is causing it. Your child's caregiver may give him dye before the pictures are taken to help him see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if your child is allergic to shellfish, or has other allergies or medical conditions.
  
  
• MRI: An MRI uses a powerful magnet and radio waves to take pictures of the inside of your child's body. Caregivers may use the MRI to look at your child's brain, muscles, joints, bones, or blood vessels. Your child will need to lie still during his test. Never enter the MRI room with any metal objects. This can cause serious injury.
  
  
• Laparoscopy: This is a procedure that uses a scope to look inside your child’s abdomen. The scope is a long bendable tube with a camera at the end. It is put into a small cut made in your child’s abdomen. Ask your child’s caregiver for more information about this procedure.
  
  
• Ultrasound: An abdominal ultrasound is a test that is done to see inside your child’s abdomen. Sound waves are used to show pictures of his hernia on a TV-like screen.
  
  
• X-ray: Your child's caregiver may take an x-ray of his abdomen. Abdominal x-rays are pictures of the organs inside your child's abdomen. Caregivers use these pictures to look for problems such as a hernia.

How is my child's ventral hernia treated?

Your child's caregiver may be able to push your child's hernia back into his abdomen without surgery. Your child may also need surgery to treat his hernia. If your child has open surgery, his caregiver will cut open your child's abdomen to fix his hernia. Your child's caregiver will find your child's hernia and cut open the tissue surrounding it. He may remove extra fat or tissue. If your child has laparoscopic surgery, small incisions (cuts) are made on his abdomen. Your child's caregiver then puts a scope and tools through these cuts and fixes his hernia. After your child's hernia is fixed, your child's caregiver will then stitch up his muscles and abdomen wall.

What problems can a ventral hernia cause in my child?

A ventral hernia may cause a bulge or swelling in your child’s abdomen. Your child may have constipation or blood in his stools. Your child's hernia may become bigger or infected. Your child may have pain that may get worse. Part of his bowel may become trapped or twisted and become blocked. Your child's bowel may not get enough blood flow and it may die.

How can I help my child prevent a ventral hernia?

Your child's caregiver may suggest any of the following:

• If your child weighs more than his caregiver suggests, losing weight may help him prevent a ventral hernia. Ask your child's caregiver for a diet that is right for your child.
  
  
• Help your child avoid straining (pushing too hard) when he coughs or cries. Ask your child's caregiver for ways to help your child avoid straining.
  
  
• Ask your child's caregiver for ways to help prevent your child from having constipation. This may help your child avoid straining when he has a BM. Exercise such as walking can help your child have regular BMs. Drinking enough water and eating foods such as fruit, bran, and prune juice may also help. Caregivers may give your child fiber medicine or a stool softener to help make his BMs softer and more regular.

When should I call my child’s caregiver?

Call your child’s caregiver if:

• You see or feel a bulge in your child’s abdomen.
  
  
• Your child has vomited (thrown up).
  
  
• Your child has a fever (high body temperature).
  
  
• Your child has constipation.
  
  
• After surgery, your child has bleeding or pus from or near his wound.
  
  
• After surgery, your child suddenly has new swelling in his abdomen.
  
  
• You have questions or concerns about your child's hernia, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• Your child’s abdomen is rigid (very hard).
  
  
• A bulge in your child's abdomen has a purple or blue color.
  
  
• Your child has pain in his abdomen or back that does not go away, even after taking pain medicine.
  
  
• After surgery, your child has bleeding from his wound that does not stop.
  
  
• Your child has new trouble breathing.

Where can I find more information?

Contact the following for more information:

• American College of Surgeons
  633 N. Saint Clair St.
  Chicago , IL 606113211
  Phone: 1- 312 - 2025000
  Phone: 1- 800 - 6214111
  Web Address: http://www.facs.org
  

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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