Abdominal Wall Defects and Hernias
Sometimes children are born with abnormalities of their abdominal wall; sometimes they develop a problem due to a surgery or trauma. However the condition arises, the experts at Mount Sinai can help, using a minimally invasive approach whenever possible.
About Abdominal Wall Defects
Sometimes a child is born with one or more abdominal organs on the outside of the body. We often need to address abdominal wall defects in several steps. The most common birth defects are:
- Gastroschisis means the baby’s intestines are outside the body, exposed through a hole near the belly button. Sometimes other organs, such as the stomach and liver, are also outside the body.
- Omphalocele occurs when the baby’s intestines, liver, or other organs are outside the body.
Hernias arise when part of an organ pushes through weak spot in the muscle wall, creating a bulge. Sometimes these are birth defects, sometimes they develop over time. The most common types of hernias we see in children are:
- Inguinal hernias affect the groin area and do not close on their own. This condition can cause the bowel to become trapped in the neck of the defect.
- Umbilical hernias, located at the belly button (umbilicus), are common and often resolve on their own. But if they don’t, we can usually fix them with an outpatient procedure.
- Diaphragmatic hernias affect the muscle that separates the thorax from the abdomen. We can find these hernias when the child is in utero or any time after.
- Incisional hernias form at the site of a healing surgical scar.
- Ventral/epigastric hernias, defects in the middle of the abdominal wall, can cause discomfort or other symptoms. You might be able to see it when your child stands up, though it is often quite small.
Diagnosis and Treatment
In general, we diagnose abdominal wall defects and hernias through physical examination. We may also need to perform an imaging test for additional information. Most commonly, we use ultrasound to better understand your child’s condition.
We offer a variety of types of surgical treatments for abdominal wall defects and hernias. Often, a multidisciplinary team works together to diagnose and treat these conditions. We use minimally invasive approaches whenever possible. Sometimes we can complete the whole process in a single procedure, and sometimes it takes several, to provide the best possible outcome.
Abdominal defects leave one or more of your child’s internal organs outside the body. We treat these conditions by enclosing the organs in some fashion, moving them back inside the body, and then closing the opening. The precise procedure varies, depending on the condition and your child’s overall health.
If your child has a hernia, we need to seal the opening, either by suturing it together or, if the hole is larger, by using a synthetic patch, then suturing it in place. We usually repair inguinal hernias with a small laparoscopic procedure. This allows us to see and repair a hernia that may be present on the other side at the same time. Children can usually go home on the day of surgery.