An abnormal swelling at the site of umbilicus which usually resolves by 2 or 3 years of age is the main symptom of umbilical hernia.
Obstruction and strangulation generally do not occur because the size of defect is generally very large.
Babies are prone to this malformation because of the process during fetal development by which the abdominal organs form outside the abdominal cavity, later returning into it through an opening which will become the umbilicus.
Hernias may be asymptomatic and present only as a bulge of the umbilicus. Symptoms may develop when the contracting abdominal wall causes pressure on the hernia contents. This results in abdominal pain or discomfort. These symptoms may be worsened with lifting and straining.
The following symptoms may indicate a more serious situation that requires medical treatment:
the baby is in obvious pain
the baby is vomiting
the bulge (in both children and adults) is tender, swollen, or discolored
There are three causes of umbilical hernia:
Congenital: The hernia occurs due to congenital malformation of the navel. In adults, the disease is more common in women. However, in children the ratio is similar.
Acquired: These included causes that raise the abdominal pressure which include; obesity, coughing, multiple pregnancies.
4 Making a Diagnosis
A doctor will perform a physical exam in order to diagnose umbilical hernia.
The doctor will see if the hernia can be pushed back into the abdominal cavity (reducible).
They’ll also examine the baby or adult to determine if the umbilical cord is trapped, or incarcerated. This is a serious complication because the trapped part of the intestine may be deprived of a blood supply.
Your doctor may take an X-ray or perform an ultrasound on the stomach area to ensure that there are no complications. They may order blood tests to look for infections, especially if the intestine is blocked or incarcerated.
There are two options available to treat umbilical hernia.
One is that the surgeon may stitch the wall of abdomen and place a mesh over the opening and stitch it together. However, most surgeons will not repair it until 4-5 years of age as it spontaneously closes in most of them without any complications.
The umbilical hernia and its contents can be easily pushed back into the abdominal cavity.
The complication incidence is very low, and in addition, the gap in the muscles usually closes with time and the hernia disappears on its own.
The treatment of this condition is essentially conservative - observation allowing the child to grow up and see if it disappears. Operation and closure of the defect is required only if the hernia persists after the age of 3 years or if the child has an episode of complication during the period of observation like irreducibility, intestinal obstruction, abdominal distension with vomiting, or red shiny painful skin over the swelling.
Surgery is always done under anesthesia, and the defect in the muscles is defined and the edges of the muscles are brought together with sutures to close the defect.
The child needs to stay in the hospital for 2 days and the healing is complete within 8 days.
6 Risks and Complications
Complications that can develop as a result of an umbilical hernia include:
obstruction – where a section of the bowel becomes stuck outside the abdomen, causing nausea, vomiting and pain
strangulation – where a section of bowel becomes trapped and its blood supply is cut off; this requires emergency surgery within hours to release the trapped tissue and restore its blood supply so it doesn't die
Surgery will get rid of the hernia and prevent any serious complications, although there's a chance of it returning after the operation.
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