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

作　　者：Tatjana T König Laura S Oerters Ljuba Spiller Martin Schwind Mark Born Christina Oetzmann von Sochaczewski Andreas C Heydweiller 

机构地区：[1]Klinik und Poliklinik für Kinderchirurgie,Universitätsmedizin der Johannes Gutenberg-Universität Mainz,Mainz,Germany [2]Sektion Kinderchirurgie der Klinik und Poliklinik für Allgemein-,Viszeral-,Thorax-und Gefächirurgie,Universität sklinikum Bonn,Bonn,Germany [3]Sektion Kinderradiologie der Klinik für Diagnostische und Interventionelle Radiologie,Universitätsklinikum Bonn,Bonn,Germany

出　　处：《World Journal of Pediatric Surgery》2023年第2期92-96,共5页世界小儿外科杂志（英文）

摘　　要：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%Cl-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.

关 键 词：DIAGNOSIS primarily otherwise 

分 类 号：R726.5[医药卫生—儿科]