Definition and Overview

Hernia is a medical term that refers to any condition that involves an internal organ pushing through an opening in tissue or muscle that is supposed to hold it in place. If a part of the intestine is protruding through an opening in the stomach muscle, it is referred to as an umbilical hernia.

Umbilical hernias are very common, affecting approximately 10% of infants and young children, especially premature babies. However, they are rarely a cause for concern. In fact, many cases resolve on their own without any medical intervention.

An umbilical hernia is easily diagnosed because of the presence of a lump in or near the belly button. Usually, it gets more noticeable when a child is coughing or crying and shrinks when the child is relaxed. The lump is also usually painless and disappears when the child reaches two or three years old.

The condition can also occur in adults, although this happens very rarely. In such cases, surgical treatment is immediately prescribed as patients are at risk of serious complications including bowel obstruction or strangulation. Umbilical hernia surgery is also performed if a large hernia has not resolved on its own by the time a child is about to go to school.

Causes of Condition

The umbilical cord is what attaches the foetus to the placenta, serving as the baby’s lifeline and source of oxygen and nutrients until it is born. Soon after birth, the umbilical cord is cut, leaving an approximately one to two-inch stump on the baby’s tummy. The stump will drop off on its own after two weeks and the belly button will take about another two weeks to heal completely.

An umbilical hernia occurs when the abdominal muscles do not close completely, resulting in a weak spot where part of the bowel or fatty tissue can poke through.

Umbilical hernias in adults can be caused by too much abdominal pressure usually due to multiple pregnancies, obesity, and previous abdominal surgery. Patients who regularly undergo peritoneal dialysis and suffering from ascites also have an increased risk of developing the condition.

Key Symptoms

The most noticeable symptom of an umbilical hernia is a soft lump or bulge in or around the belly button. It is usually painless and in mild cases, can be pushed back using a finger. The lump normally becomes more noticeable when a child cries, laughs, or coughs and may disappear when the baby lies on his back or is calm.

However, in some cases, babies can experience pain and vomit. When this happens, it is important that they receive immediate medical attention.

Umbilical hernia symptoms in adults are quite different as the bulge usually causes abdominal discomfort. It also puts patients at risk of bowel obstruction or strangulation, which is a serious medical condition that requires surgery.

Who to See and Types of Treatments Available

An umbilical hernia is diagnosed through a physical exam. Other tests, such as computed tomography (CT) scan and abdominal ultrasound may also be carried out to check for possible complications.

Unless there are complications, doctors usually advise watchful waiting for infants and young children. In many cases, treatment is not necessary as the condition resolves on its own usually before the patient turns a year old. However, an umbilical hernia repair is advised for adult patients as they face risks of serious complications.

An umbilical hernia operation is an outpatient procedure that takes less than an hour. It is usually performed under general anaesthesia. The surgery can also be done in younger patients if the hernia is quite large or has not disappeared by the time they reach four or five years old.

For the procedure, the surgeon will make an incision at the base of the belly button to access and seal the weak spot in the abdominal wall with stitches. In certain cases, a special mesh is used to strengthen the affected area. Most patients, both children and adults, are able to fully recover after a couple of weeks without problems or any complications.

However, just like any other surgical procedure, surgery for the treatment of an umbilical hernia has risks. Patients may suffer from infection, headaches, and numbness in the legs a few hours after the procedure.

References:

  • Hernias of the abdominal wall. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/gastrointestinaldisorders/acuteabdomenandsurgicalgastroenterology/herniasoftheabdominal_wall.html#v890814.

  • Umbilical hernia repair. Retrieved from http://www.nhs.uk/conditions/Umbilicalhernia/Pages/Whatisitpage.aspx

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