Umbilical Hernia: Causes, Symptoms & Treatment
An umbilical hernia occurs when tissue pushes through a weak spot in the abdominal muscles near the navel. It is common in infants and adults alike.
Things worth knowing about "Umbilical hernia"
An umbilical hernia occurs when tissue pushes through a weak spot in the abdominal muscles near the navel. It is common in infants and adults alike.
What Is an Umbilical Hernia?
An umbilical hernia is a type of hernia in which fatty tissue or part of the intestine protrudes through a weakness in the abdominal wall near the navel (belly button). This creates a visible or palpable bulge in the navel area. Umbilical hernias are among the most common types of hernia and can affect both newborns and adults.
Causes
The causes of an umbilical hernia differ depending on the age group:
In Infants and Young Children
- Incomplete closure of the abdominal wall after birth: After the umbilical cord is cut, the abdominal wall normally closes on its own. If a gap remains, an umbilical hernia can develop.
- Premature birth and low birth weight increase the risk.
In Adults
- Increased intra-abdominal pressure due to obesity, pregnancy, or repeated straining (e.g., from chronic constipation or persistent coughing).
- Previous abdominal surgeries that have weakened the abdominal wall.
- Ascites (fluid accumulation in the abdominal cavity), for example in liver disease.
- Heavy physical labor or intense exercise.
Symptoms
Symptoms can vary depending on the size and severity of the hernia:
- A visible, soft bulge near the navel that becomes more prominent when straining, coughing, or crying.
- Mild pressure or pulling sensation in the navel area.
- In infants, the hernia is usually painless and only appears when crying.
- In adults, pain may occur, particularly during physical activity.
- Incarceration (strangulation): In rare but serious cases, the contents of the hernia can become trapped. Signs include sudden severe pain, redness of the skin over the bulge, nausea, and vomiting. This is a medical emergency.
Diagnosis
An umbilical hernia is usually diagnosed through a physical examination. The doctor palpates the bulge and checks whether the hernia contents can be pushed back (reducible). Additional diagnostic tools may include:
- Ultrasound (sonography): To assess the size, contents, and potential complications of the hernia.
- CT or MRI scan: Used in unclear cases or when complications are suspected.
Treatment
In Infants and Young Children
In young children, umbilical hernias often close on their own by the age of 2 to 4 years. Surgery is generally considered only if:
- the hernia has not resolved by school age,
- it is very large (more than 1.5 cm in diameter), or
- incarceration occurs.
In Adults
Umbilical hernias in adults do not heal on their own and are typically treated surgically to prevent the risk of incarceration. There are two common surgical approaches:
- Open surgery (conventional): The surgeon closes the hernia opening using sutures or a synthetic mesh through a small skin incision.
- Laparoscopic (minimally invasive) surgery: Small incisions are made and a camera with specialized instruments is used. This approach often allows for faster recovery and less scarring.
After surgery, heavy physical activity should be avoided for several weeks. Recurrence is possible but rare when the repair is performed correctly.
When to See a Doctor?
If you experience a sudden increase in pain, hardening of the bulge, skin redness, or vomiting, you should seek emergency medical attention immediately, as this may indicate incarceration of the hernia.
References
- Miserez, M. et al. - The European Hernia Society groin hernia classification: simple and easy to remember. Hernia, 2007.
- Muschaweck, U. - Umbilical and epigastric hernia repair. Surgical Clinics of North America, 2003.
- European Hernia Society (EHS) - Guidelines on umbilical and epigastric hernias, 2015. Available at: www.herniasociety.eu
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