Epigastric hernias in children and the use of ultrasound in its diagnosis.

Autor:	König TT; Klinik und Poliklinik für Kinderchirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany., Oerters LS; Sektion Kinderchirurgie der Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Bonn, Germany., Spiller L; Sektion Kinderradiologie der Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Bonn, Bonn, Germany., Schwind M; Klinik und Poliklinik für Kinderchirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany., Born M; Sektion Kinderradiologie der Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Bonn, Bonn, Germany., Oetzmann von Sochaczewski C; Sektion Kinderchirurgie der Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Bonn, Germany., Heydweiller AC; Sektion Kinderchirurgie der Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Bonn, Germany.
Jazyk:	angličtina
Zdroj:	World journal of pediatric surgery [World J Pediatr Surg] 2023 Apr 06; Vol. 6 (2), pp. e000544. Date of Electronic Publication: 2023 Apr 06 (Print Publication: 2023).
DOI:	10.1136/wjps-2022-000544
Abstrakt:	Introduction: There is a paucity of clinical data on pediatric epigastric hernias despite them accounting for up to 6% of all hernia repairs in children. We aimed to provide additional data to supplement those 117 cases of a recent systematic review and to further clarify the role of ultrasound in diagnosing pediatric epigastric hernia. Methods: We retrospectively included all 60 patients treated for epigastric hernias in children in two tertiary pediatric surgical departments within 12 years. Associations were tested via point-biserial correlation analyses. Results: Epigastric hernias primarily affected preschool children with a median age of 39 months. The vast majority of patients (88%) presented with swelling that was occasionally (30%) accompanied by pain. Fascial defects could be found during clinical examination in 45% of patients with a median size of 5 mm (95% CI 3 to 10). Smaller defects were less likely to be palpable (r=-0.44, 95% CI -0.08 to -0.7, p=0.021). Likewise, ultrasound was used more frequently with smaller fascial defect sizes (r=-0.51, 95% CI -0.16 to -0.74, p=0.007). Laparoscopic repair was used in 11 patients (19%) and more often (4/11) in combination with another simultaneous procedure than open repair (11/48). Conclusions: Epigastric hernias are primarily a condition of the preschool child. Ultrasound can be beneficial if the diagnosis cannot be made clinically; otherwise, it is abdicable if it does not change the management of the patient's epigastric hernia. Laparoscopic repairs might be beneficial for children with multiple defects or simultaneous procedures. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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