What Is an Infant Umbilical Hernia?

Umbilical hernia is a developmental defect that is common in infants and has a significantly increased incidence in immature infants, especially 75% of infants weighing less than 1500g. Umbilical hernias have an increased incidence in certain special diseases, such as Beckwith-Wiedemann syndrome, congenital syphilis, etc. Umbilical hernias have a high rate of self-healing, which gradually decreases with age and rarely extends to school age.

Basic Information

Visiting department

Pediatrics

Common causes

Anatomy of the Umbilical

Common symptoms

Umbilical foldable mass

Contagious

no

Causes of infant umbilical hernia

The cause of umbilical hernia is related to the anatomical characteristics of the umbilicus. During the fetal period, the lower half of the umbilical ring passes through the umbilical artery and the umbilical duct, and the upper part of the umbilical ring passes through the umbilical vein. After the baby is born, these channels are immediately closed and become fibrous cords, which heal with the scarred skin after the umbilical cord has fallen off. This part is a weak area. The formation of umbilical hernias is also related to the development of abdominal wall muscles. During infancy, both rectus abdominis and anterior and posterior sheaths have not been closed at the umbilicus, which makes umbilical hernias easier to produce. Under the above conditions, Various causes that increase the pressure in the abdominal cavity, such as cough, diarrhea, excessive crying, etc., can promote the contents of the abdominal cavity to pass through the unhealed umbilical ring. The prominent internal organs are mostly the omentum or small intestine, and there is generally no adhesion between the sac wall and its contents.

Clinical manifestations of infant umbilical hernia

The umbilical recoverable mass is the most important clinical manifestation. When the child is quiet and in the supine position, the mass disappears. When the baby crying, standing or exercising increases the intra-abdominal pressure, the mass is prominent and the intra-abdominal cavity is prominent. The higher the pressure, the larger the mass, the tighter the skin outside the hernia, and sometimes the color is transparent. Generally no other symptoms. Because the baby's abdominal wall and hernia ring are relatively soft, incarceration is rare. Pediatric umbilical hernias may rupture concurrently, but are extremely rare.

Infant Umbilical Hernia Treatment

Smaller umbilical hernias, such as less than 1.5 cm in diameter, can mostly heal with the development of the abdominal wall within 2 years of age. In view of the rare occurrence of incarcerated umbilical hernia in infants, non-surgical treatment can be performed first. Adhesive tape application therapy is adopted. That is, take a wide strip of tape to pull the two sides of the abdominal wall to the midline and fix it to prevent the hernia from protruding and keep the umbilicus in place. No tension, and the umbilical foramen gradually healed and locked. Replace the adhesive tape once a week. If there is adhesive tape dermatitis, you can use an abdominal band to apply appropriate pressure bandaging.

If the child is over 2 years old and the umbilical hernia has not healed, surgery should be performed. The specific method of surgery is to make a corresponding arc-shaped incision at 1-2 cm below the umbilical hernia, free the flap, and expose the anterior sheath of rectus abdominis on both sides. Cut the abdominal white line and hernia sac, or cut the peritoneum if there is no complete hernia. The ileum is received, the hernia sac is removed, and the peritoneal margin is sutured at the hernia ring. Suture the abdominal transverse fascia horizontally, and then suture the abdominal white line longitudinally to close the umbilical ring and repair the weak area of the abdominal wall. Finally, the flap retaining the umbilical hole is sutured in place.