What is an Umbilical Hernia?

An umbilical hernia is an extra-abdominal hernia whose contents of the abdominal cavity protrude from a weak area of the umbilicus. The umbilicus is located in the middle of the abdominal wall and is the latest closed part of the abdominal wall during embryonic development. The lack of adipose tissue in the umbilicus makes the skin, fascia and peritoneum of the outermost layer of the abdominal wall directly connected, becoming the weakest part of the abdominal wall. The contents of the abdominal cavity easily protrude from this part to form an umbilical hernia.

Basic Information

nickname

Umbilical process

English name

umbilicalhernia

Visiting department

Pediatrics

Common locations

Umbilical

Contagious

no

Causes of umbilical hernia

Infant umbilical hernia

Commonly known as "qi navel", it is congenital and is one of the common diseases in newborns and infants. After the umbilical cord is detached, the umbilical scar area passes through the abdominal wall due to the fetal stage, which is a congenital weakness of the abdominal wall; in infancy, the abdominal muscles on both sides are not completely closed at the midline, leaving a defect, which is medically called the umbilical ring . Excessive crying, coughing, diarrhea, etc., cause increased intra-abdominal pressure, which will cause the contents of the abdominal cavity, especially the small intestine, along with the peritoneum and abdominal wall skin to gradually push out from the umbilicus, forming an umbilical hernia.

2. Adult umbilical hernia

Rarely. May be related to weakened scar tissue at the umbilical ring. Causes include pregnancy, chronic cough, and peritoneal effusion. The contents of the hernia are initially the omentum, followed by the small intestine and colon. Often due to extensive adhesions to the hernia sac wall, a multi-atrial space is formed.

Clinical manifestations of umbilical hernia

Infant umbilical hernia

Most are recurrent hernias, which are more common, and incarceration is rare. When crying, standing, and strenuously, the umbilicus bulges with a mass of 1 to 2 cm in diameter. It has no other symptoms and is often found inadvertently in the bath and changing clothes. Mostly hemispherical or cylindrical, there is a small scar on the top of the mass, which is an umbilical scar; the mass is characterized by reversibility, that is, crying, coughing, fullness and enlargement of the mass when standing upright, and the mass is relatively firm; When the child is quiet or the parent presses with their hands, the mass shrinks or returns to the abdominal cavity of the person, accompanied by bowel sounds. After the mass has been reduced or accepted, there are loose skin wrinkles in the area. The above are typical umbilical hernias. When the mass is large, especially when the child is crying, the skin on the outside appears thin and shiny. Some parents worry that the umbilical hernia will be broken. In fact, due to the elasticity and toughness of the skin, it does not exist. The possibility of rupture, unless caused by trauma.

2. Adult umbilical hernia

More common in middle-aged obese women. The main symptom is a hemispherical hernia in the umbilicus, which can be accepted, accompanied by indigestion, abdominal discomfort, and dull pain. Hernia rings are usually small and the surrounding scar tissue is tougher and more prone to incarceration and strangulation. The huge umbilical hernia is hanging.

Umbilical hernia diagnosis

Can be diagnosed based on medical history and clinical symptoms.

Differential diagnosis of umbilical hernia

The disease should be distinguished from inguinal hernia, straight hernia, and femoral hernia.

Umbilical hernia treatment

Infant umbilical hernia

Most umbilical hernias heal within one year by progressive contraction of the umbilical fascial ring. Therefore, until 2 years old, you can observe and wait unless incarcerated. Use non-surgical therapy to promote self-healing. If you are 2 years old and the diameter of the umbilical hernia exceeds 1.5 cm, surgery should be performed. Make a semi-circular incision along the umbilical mouth and cut the skin and subcutaneous tissue to expose the rectus abdominis sheath, hernia ring and hernia sac, cut the white line in the middle, free the hernia sac, and accept the contents After the partial hernia sac was removed at the hernia ring, suture was given, and then the edges of the rectus abdominis sheaths (that is, the abdominal line) were intermittently sutured, and the skin was finally sutured.

2. Adult umbilical hernia

Surgical treatment should be performed early, and emergency surgery should be performed immediately. Make a horizontal elliptical incision around the umbilicus, separate the hernia sac to the neck, separate adhesions, cut off at the neck of the hernia sac, remove the hernia sac along with the tightly attached, difficult to separate omentum and excess skin. Free the transverse fascia and peritoneum around the hernia ring as much as possible. The horizontal butt suture is used to free the rectus abdominis and its aponeurosis on the upper and lower sides, and overlap suture if necessary.