GI - Hernias

Question 1

What are the 3 commonest paediatric hernias?

Answer 1

1. Congenital Inguinal Hernias.
2. Infantile Umbilical Hernias.
3. Congenital Diaphragmatic Hernias.

Question 2

Presentation of Congenital Inguinal Hernias (2).

Answer 2

1. 60% Right-Sided.

2. 10% Bilateral.

Question 3

Risk Factors of Congenital Inguinal Hernias (4).

Answer 3

1. Premature babies.
2. Males.
3. Connective Tissue Disorders.
4. Raised Intra-Abdominal Pressure (e.g. Cystic Fibrosis, Prematurity).

Question 4

Aetiology of Congenital Inguinal Hernias.

Answer 4

They are indirect hernias, resulting from a patent Processus Vaginalis.

Question 5

Management of Congenital Inguinal Hernias (2).

Answer 5

1. Surgical Repair - Herniotomy ASAP due to high risk of incarceration..
2. Keep neonates and premature infants in hospital overnight due to risk of post-operative apnoea.

Question 6

Presentation of Infantile Umbilical Hernias.

Answer 6

Symmetrical bulges under Umbilicus.

Question 7

Risk Factors of Infantile Umbilical Hernias.

Answer 7

1. Premature Babies.
2. Afro-Caribbean Ethnicity.
3. Down’s syndrome.
4. Mucopolysaccharide Storage Disease.

Question 8

Prognosis of Infantile Umbilical Hernias.

Answer 8

Resolve without intervention by the ages of 4-5.

Question 9

Aetiology of Congenital Diaphragmatic Hernias.

Answer 9

Incomplete formation of the Diaphragm and failure of Pleuroperitoneal Canal to close completely.

Question 10

Clinical Features of Congenital Diaphragmatic Hernias.

Answer 10

1. Pulmonary Hypoplasia.
2. Hypertension.
3. Respiratory Distress that shortly occurs after birth.

Question 11

Prognosis of Congenital Diaphragmatic Hernias.

Answer 11

Only 50% of newborns with Congenital Diaphragmatic Hernias survive despite modern medical interventions.