Hernia – Hydrocephalus
Hernia, or rupture, is an outpouching or pocket of the abdominal
cavity which protrudes through a defect in the abdominal wall. An
abdominal organ may bulge through this defect, becoming larger when the
child cries or strains. The bulge usually becomes smaller or disappears
when the child relaxes. It is one of the most common conditions
requiring an operation during infancy or childhood. The danger of a
hernia is that a loop of intestine gets stuck in the hernia sac, causing
an intestinal obstruction. If not reduced either manually or by
operation promptly, the intestine can perforate, leading to peritonitis.
Both inguinal (groin) and umbilical (navel) hernias are common. Inguinal
hernias are six
Location of inguinal hernia
An inguinal hernia allows a loop of intestine to slip through the
abdominal wall and into the groin or scrotum.
times as common in boys as girls. They do not correct themselves and are
most likely to trap a loop of intestine. They usually appear as an
intermittent gi’oin or scrotal mass. Occasionally the intestine may be
trapped the first time it is seen as a mass in the groin. An
incarcerated hernia (one which contains trapped intestine) requires
prompt attention. These hernias can be noted first at any age, but are
present most often during infancy. All hernias should be seen by a
doctor. Inguinal hernias are frequently present on both sides. An
operation is required for correction. This operation can be performed
safely at any age in an otherwise healthy baby. Almost all hernia
operations in pediatric patients are performed under general anesthesia
as an outpatient, and the child can be sent home when fully awake from
anesthesia. Convalescence takes only a few days.
If your child has an inguinal hernia for which no immediate operation is
planned, watch it carefully. If the child feels pain in the area of the
hernia, or if you cannot gently push the intestine back into the
abdomen, call your doctor immediately.
Umbilical hernias result from enlargement of the normal defect in the
fascia (fibrous tissue which covers muscle) which carries the umbilical
cord blood vessels to the baby before birth. These hernias tend to
correct themselves by two to four years of age. It is rare for a loop of
intestine to get stuck in an umbilical hernia during childhood.
Umbilical hernias do cause problems in adults, and so a school-age child
who has this kind of hernia should be seen by a doctor. Repair is
generally performed as an outpatient under general anesthesia.
Other hernias are quite uncommon in children, but you should notify your
doctor promptly if you notice a bulge in your child’s body tissue.
Sometimes, a hernia is confused with a hydrocele (a collection of fluid
in the sac surrounding the testicle). Frequently, a boy may have both a
hernia and a hydrocele. If he does, the doctor will probably want to
repair both in the same operation, [t.m.h.]
See also Hydrocele
Herpes simplex. See Fever blisters
Hiccups occur when short, jerky contractions of the diaphragm
interrupt the breathing cycle. The diaphragm, a large muscle that
divides the chest from the abdomen, normally contracts and relaxes
rhythmically to aid breathing. But sometimes the diaphragm contracts
suddenly and air is pulled through the larynx (voice box). The air hits
the vocal cords and the epiglottis (the cap on top of the larynx) and
produces the “hie” sound.
Babies have hiccups frequently—sometimes several times a day. Burping
or a drink of warm water may help a baby stop hiccuping. Older children
may be helped by drinking water or some other common remedy, such as
holding their breath, breathing into a paper bag, or eating a teaspoon
of sugar. Usually, however, hiccuping stops by itself after a few
minutes. In rare instances, hiccups continue for several hours. If this
happens to your child, call your doctor, [m.g.]
Hip. congenital dislocation. In congenital dislocation of the hip,
the ball of the thighbone is not in the socket formed by the pelvic
bones. The actual dislocation may occur before, during, or shortly after
birth. Although the exact cause is unknown, heredity is believed to be a
significant factor. The condition is more common in girls than in boys.
It is a serious problem and must be corrected at an early age if a child
is to have normal hip function during life.
Congenital dislocation usually affects only one hip. The affected leg is
shorter. The skin folds in the upper thigh and buttock are different
from the opposite side. A dislocated hip prevents the thigh from bending
out as far as normal. Putting diapers on the baby may be difficult. If
the dislocation is not discovered before the child walks, a pronounced
limp will be noticeable.
If you think your child has a congenitally dislocated hip, consult your
doctor. The condition should be treated as early as possible, preferably
by 3 months of age. Early treatment may take any of several different
approaches. Double diapering or the use of splints is commonly
prescribed. In more severe cases, casts and sometimes surgery may be
necessary, [jj.g.]
Hives are an allergic reaction of the skin. They look like mosquito
bites—raised, whitish welts on reddened skin—and they often itch.
Hives may last for a short time and suddenly disappear, or they may
continue for months. They may occur anywhere on the body. Sometimes,
swelling occurs around the eyes or lips. In rare cases, swelling occurs
inside the throat or larynx and interferes with breathing. Prompt
medical or surgical treatment may be required. Consult your doctor if
you suspect that your child has hives. The doctor may recommend that you
take the child to an allergist (a doctor specializing in the treatment
of allergies).
A child may be allergic to such foods as milk, eggs, fish, nuts,
berries, shellfish, or pork. Eating them or inhaling their odors may
cause hives. Keeping a record of what your child eats and systematically
eliminating certain foods from the diet may help determine which foods
cause the allergic reaction.
Certain drugs such as aspirin, antibiotics, and vitamins can also cause
hives. A child who is highly sensitive to penicillin may even break out
in hives after drinking milk from cows that have received the
antibiotic.
The stings of bees, wasps, hornets, or yellow jackets may cause hives
and swelling in a susceptible child. The child can be desensitized to
the stings over a period of years. The doctor will give the child
repeated injections of gradually strengthened insect venom.
Hives may occur after the child has had an infection of the ears,
sinuses, teeth, tonsils, or other body parts. Hives can develop when the
child comes into contact with cosmetics, wool, or other substances.
Hives can result from sensitivity to cold, heat, or light. Food
preservatives and other substances may cause hives. Psychological
factors may be the cause of hives.
Doctors treat hives by trying to discover and eliminate the cause. They
may prescribe antihistamines, tranquilizers, or adrenalin to relieve
some of the symptoms. [j.s.h.]
See also Allergy
Humidifying a child’s room is often recommended by a doctor when the
child has
bronchitis, a cold, croup, laryngitis, whooping cough, or other diseases
that make breathing difficult. Humidifying provides moisture that can
loosen secretions in the child’s bronchial tubes and nasal passages and
make breathing easier.
The safest way to add moisture to the air is with a cold-mist
humidifier. A hot-steam humidifier is dangerous because a child may get
burned by touching it or knocking it over. [m.g.]
See also Croup
Hydrocele is a collection of fluid in the sac surrounding the
testicle. You may first notice it as a swelling of the scrotum (the
pouch that contains the testicles). A hydrocele is often confused with a
hernia, and it frequently occurs with a hernia. The swelling from a
hydrocele alone, however, remains about the same size all the time, and
the swelling from a hernia tends to come and go. If your son has a
scrotal swelling, have a doctor examine him.
An acute hydrocele, one that appears abruptly, may be caused by an
infection around the testicle or by a twisting of the testicle inside
its sac that cuts off the blood supply to the testicle. This type of
hydrocele causes severe pain and should be examined by the doctor at
once.
A hydrocele in a boy less than a year old may disappear without any
treatment unless it is acute. If a boy is older, or if he has an acute
hydrocele, an operation and a day or two of recuperation in the hospital
may be necessary, [t.m.h.]
See also Hernia
Hydrocephalus. The brain is suspended within the skull in clear and
watery cerebrospinal fluid. This fluid also occupies four interconnected
cavities (ventricles) within the brain. Cerebrospinal fluid, continually
secreted by organs within the brain, flows through the ventricles and
into the space around the brain, where it is absorbed into the
bloodstream. Normally, the amount of fluid stays the same, because it is
absorbed at the same rate it is secreted. Sometimes, however, the amount
of cerebrospinal fluid
increases abnormally. This condition is called hydrocephalus.
The most common cause of hydrocephalus is an obstruction in the pathway
of the cerebrospinal fluid. The obstruction keeps the fluid from being
absorbed as fast as it is secreted. As a result, the volume of fluid
increases, enlarges the ventricles, and compresses the brain. Brain
damage can occur.
Hydrocephalus most frequently occurs in young infants with
underdeveloped pathways for the cerebrospinal fluid. The earliest sign
is an abnormally rapid rate of growth of the baby’s head. The brow
enlarges, and the scalp is shiny. The fontanels (soft spots) may bulge.
Because the compressed brain does not function normally, the infant may
also fail to develop on schedule such skills as sitting, crawling, and
standing.
Hydrocephalus is often treated by providing an artificial drainage route
for the cerebrospinal fluid from the ventricles into the abdomen. In one
method, a small plastic tube is placed in one of the cerebral
ventricles. It leads down through the body and drains into the abdomen.
In some cases, hydrocephalus may stop by itself.
Early detection of hydrocephalus requires attention to head
circumference during the first two years of life. Routine examinations
by a doctor during these years usually include measuring the head size
of the child, [a-g.s.]
See also Soft spots
Hysteria (conversion reaction) is a mental illness that may occur
suddenly in adolescents or preadolescents. The child may develop what
appears to be a physical disability, even though a medical examination
shows that there is no physical cause for it. A seeming paralysis of an
arm, a leg, or another part of the body is a common symptom of hysteria.
Prickling, tingling, or creeping sensations are also common. Other
symptoms include blindness or decreased vision, deafness, inability to
speak or to speak above a whisper, fainting spells, convulsions, and
inability to urinate.
Usually, children with hysteria are unconcerned about their symptoms,
and the symptoms may worsen if the child receives extra
attention. A child with hysteria may require psychiatric help.
The word “hysterical” is not always connected with the illness hysteria.
“Hysterical” usually means a lack of control over laughing, crying,
rage, or other emotions. These outbursts can occur in any child.
[m.g.]
