Umbilical Hernia

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Umbilical hernias are a relatively common condition and occur when there is an area of weakness in the muscle wall that allows the bowel to push through.

What is an umbilical hernia?

An umbilical hernia is a protrusion caused when a portion of the intestine pushes through a weak spot in the muscle wall of the abdomen at or near the bellybutton. The condition is most common in infants and often resolves without treatment during the first year or two of life. Adults can have umbilical hernias, but they are seen much less often in adulthood.

Causes of umbilical hernia

Umbilical hernias in infants can develop if the muscles around the umbilical cord fail to close completely after birth. This weakness allows the bowel or fatty tissue to push through the wall during infancy, childhood or adulthood. Activities that increase abdominal pressure make herniation more likely.

The following factors increase the risk of developing an umbilical hernia:

  • Premature birth or low birth weight
  • Obesity
  • Multiple pregnancies
  • Previous history of abdominal surgery
  • Chronic cough
  • Ascites – a fluid accumulation in the abdomen
  • Long-term peritoneal dialysis

Symptoms of umbilical hernia

The most common symptom of umbilical hernia is a soft bulge that is felt or seen in the area of the umbilicus, or bellybutton. Often the bulge is movable and can be gently pushed back into the abdominal wall without discomfort.

In babies, the swelling may not be evident until the baby cries, laughs, coughs or strains pushing the intestine through the opening in the abdominal wall.

Symptoms that indicate an umbilical hernia may need emergency medical attention include the following:

  • Pain at the hernia site
  • Vomiting
  • The hernia is increasing in size
  • Discoloration of the hernia bulge develops
  • Pain or difficulty reducing the hernia back into the opening in the muscle wall

Most umbilical hernias are harmless, but complications can occur. When the protrusion becomes caught, it becomes impossible to push the bulge back into the abdominal wall. Umbilical hernias that are trapped or incarcerated can suffer interrupted blood supply causing tissue death or serious infection. This is a medical emergency.

Umbilical hernia diagnosis

Most umbilical hernias are diagnosed upon physical examination. Imaging tests such as CT or ultrasound may be ordered to determine the risk of complications.

Umbilical hernia treatment

In young children, umbilical hernias may resolve spontaneously without medical treatment. Childhood hernias larger than half an inch, those that continue to grow, become incarcerated or are still present at age 4 should be surgically repaired.

The majority of umbilical hernias in adults require surgery to prevent complications from developing.

Umbilical hernia repair involves reducing the hernia back into the abdominal cavity and closing the hole in the abdominal wall. Surgical mesh may be used to further strengthen the weakened area to prevent future reherniation.

 

General Surgery

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