Approximately four children suffer from umbilical fistula. You can get sick in childhood and in adulthood. The fistula of the navel in the newborn is formed during healing. Adults experience a fistula with inflammation of the abdominal region.
What is a navel fistula
A fistula is a hole in the navel that goes to the internal organs. To determine that the wound passes through, you can use a medical probe. It is inserted into the hole. If the probe goes more than 1.5 centimeters, then they say from the umbilical fistula.
When cutting the umbilical cord, a newborn has a small wound that heals within 2-3 weeks. In the first days, there are small discharges, but then they pass. If the ichor does not stop or its quantity increases, then the presence of a fistula is assumed. Depending on the closure of the duct, complete and incomplete fistulas are distinguished.
In the full version, the duct is completely open. There are purulent discharges and the skin turns red around the navel, partially dies off.
Incomplete fistula occurs when the duct is not completely closed,discharges are small, but they do not stop over time.
An inexperienced parent can easily confuse a newborn's navel fistula with a long-healing navel. Therefore, the pediatrician and the nurse at the reception must evaluate how the navel heals.
Fistula symptoms
A fistula in a newborn is a hole that never heals. But it is almost impossible for a parent to see a deepening. First of all, you need to know the signs in order to understand what the fistula of the navel looks like in a newborn. The symptoms of a complete and incomplete fistula may differ.
Signs of a complete umbilical-vesical fistula:
- a bright red ichor is formed at the bottom of the navel;
- urine or feces coming out of the navel;
- prolonged irritation with secretions leads to reddening of the skin and its death on the abdomen;
- body temperature rises;
- presence of an unpleasant smell;
- part of the small intestine may appear in the umbilical wound;
- the umbilical wound bulges from tension during crying or screaming.
When an incomplete fistula of the navel of newborns, the symptoms occur as follows:
- the navel has visual changes, loses its rounded shape;
- discharge comes out purulent or slimy;
- temperature rising;
- discharge has an unpleasant odor.
Causes of occurrence
The causes of the pathology are still unclear. A fistula can form in a baby a few months after healingwounds. The umbilical cord linked the baby to the mother in utero. During cutting, a small tail remains on the child's stomach. The yolk duct should be overgrown, but this does not always happen. An open duct that does not heal becomes a fistula.
Doctors identify the causes of the fistula of the navel in a newborn, which increase the risk of developing pathology:
- abdominal muscle weakness;
- violation when cutting the umbilical cord;
- pinched umbilical hernia;
- damage to the small intestine.
These factors prevent the formation of connective tissue in the hole. This pathology is common, a partial fistula does not always require treatment and can resolve on its own after a few months.
Types of fistulas
A navel fistula in a newborn is most often umbilical-intestinal and umbilical-vesical. Thus, it is possible to determine where the hole is located - between the wound and the intestines or bladder.
Umbilical-intestinal fistulas have a second name - bile duct fistulas. During the cutting of the umbilical cord, the bile duct should form, but for some reason this does not happen. In this case, the umbilical process of the baby keeps for a long time, after falling off, a hole appears, inside of which a red or pink mucous membrane is clearly visible, on which the liquid is located. In the case of a complete fistula, feces can be found in the passage.
Vesico-umbilical fistulas appear when the urinary tract is not closed. In appearance, the hole does not differ from the others. It is lined with red mucous and has discharge. When the child is tense, drops of urine come out of the navel. The more the baby pushes, the more intense the discharge. If the fistula is large, urine may drain in full.
Causes of vesico-umbilical and umbilical-intestinal fistulas
A navel fistula in a newborn can be congenital and appear as a result of a difficult pregnancy or acquired against inflammation or surgery.
A newborn is diagnosed with pathology in the first weeks of life. An incomplete fistula is formed as a result of non-union of tissues that should close the vitelline duct. This condition is quite common among infants and resolves within 6 months.
Full fistula is formed when the connective tissue is disturbed or infectious inflammation. A large opening allows bacteria to enter and increases the risk of complications. In this case, there is practically no chance that the fistula will overgrow. In this case, surgery is required.
In adults and children, a fistula can form as a result of prolonged infectious inflammation in the abdomen. A purulent mass will appear through the wound, the wound bleeds and emits a fetid odor. In this case, the risk of intestinal obstruction increases.
Diagnostics and treatments
Preliminary diagnosis doctors can expose the child in the last stages of pregnancy or at birth. An accurate diagnosis is based on the results of an abdominal ultrasound or fistulography.
Another method for diagnosing throughorifice is a probe that is inserted into the navel. If the equipment has penetrated more than 1.5 cm, then the diagnosis is confirmed.
How to treat an umbilical fistula in newborns depends on the type of passage. An incomplete fistula is treated with conservative methods that enhance tissue regeneration and prevent inflammation. These include a weak solution of potassium permanganate, treatment with hydrogen peroxide and a solution of chlorophyllipt. All these drugs are included in the list of essentials in the first-aid kit of a newborn.
Shallow incomplete fistula overgrows within 6 months, if this does not happen, then a planned operation is prescribed. Before surgery or overgrowing of the hole, you should regularly examine the navel for inflammation.
Complete fistula of the navel is treated with surgery, conservative methods have no effect due to the constant release of fluid through the navel.
Surgery
Full fistula operation in a newborn is performed under general anesthesia. The surgeon dissects the abdominal cavity from the navel to the pubic bone. The doctor sews up a hole near the navel. Depending on the type of cavity, there is a restoration of defects in the intestine or bladder. In both cases, operations are carried out similarly.
Incomplete fistula is treated conservatively, with regular inspection of the navel. With the development of infectious inflammation, an increase in the risk of infection of the bladder, an operation is performed. In case of fever, large discharge of pus and redness of the abdomen, you should immediately consult a doctor.
Disease prevention
Prevention of umbilical fistula does not exist, as the causes of occurrence are still unclear. But there are a number of rules, following which you can reduce the risk of infection and prevent the recurrence of a through hole in the abdominal cavity:
- Daily meticulous hygiene. Bathing your baby during the newborn period is the main way to keep the body clean. Regular bathing of the baby is a must.
- A newborn before the healing of the umbilical wound and after the fusion of the fistula is bathed only in boiled water.
- If necessary, add potassium permanganate to the bath. This contributes to the disinfection of water.
- Do not let the baby cry for a long time and strain the abdominal muscles. The chair should be regular and mushy. Constipation leads to tension in the abdominal muscles.
Baby first aid kit
To maintain hygiene and treat the navel, parents should have a first-aid kit for a newborn at home. The list of necessary funds can be divided into four groups:
- hygienic supplies;
- for umbilical wound treatment;
- antipyretic;
- from infantile colic.
Hygiene items include sterile cotton, wet wipes, baby nail scissors, baby or diaper cream, powder.
To treat the umbilical wound, you will need brilliant green, cotton swabs, hydrogen peroxide.
From infantile colic at home should be kept safeheating pad, gas tube, colic.
Antipyretics include drugs with paracetamol or ibuprofen. Have been using them since 3 months. Other means for the baby should not be used.
