How To Recognize An Umbilical Hernia?

In most cases, umbilical hernias present as a protrusion of the navel ring (umbilicus). Upon palpating the child’s navel, it feels soft and empty (although it might not be). If you push through the navel, sometimes the contents of the hernia can return back into the abdomen. If that occurs, the hernia is said to be “reducible”.

For such children, the first symptoms are generally irritability associated with pain around the belly button. This indicates that the umbilical ring is very small and the abdominal contents are pushing through in order to make their way through the ring.

Dealing with an Umbilical hernia

Most people live a happy life and grow old with an umbilical hernia. In those cases, the defect does not impair the quality of life and does not cause any symptoms. However, some parents might choose to opt for surgical repair either for cosmetic reasons, or because the hernia is causing a lot of pain.

Another indication for surgical correction would be the presence of signs and symptoms of strangulation, which include:

- Pain around the navel accompanied by vomiting: sometimes, the child could also present with food aversion because of the pain and the vomiting.

- Skin discoloration (due to obstruction of blood flow to the area resulting in necrosis of surrounding tissue)

- Skin irritability and

- Fever (secondary to concomitant infection)

The choice of proceeding with surgical repair also depends on the age of the child. For children younger than 2 years of age and who present with no symptoms, it is generally advisable to delay surgery until the child is at least 4 years old (at which time his/her body is surely better able to handle stress related to surgery). However, if the child is younger than 4 years and presents with signs and symptoms of strangulation, surgery is not an option anymore, but rather, an emergency.

Surgery might also be recommended sooner if the hernia is large, causing discomfort, or there's a concern about the possibility of complications. It's rare, but an umbilical hernia can lead to complications, such as incarceration or already mentioned strangulation.

Incarceration​ is a complication when a portion of the intestine becomes trapped in the hernial sac and cannot be easily pushed back in. It can lead to bowel obstruction.

The surgery, called herniorrhaphy, is relatively straightforward. It involves making a small incision near the umbilicus, pushing the protruding tissue back into the abdomen, and then stitching the muscle closed.

Post-operative care typically involves keeping the area clean and watching for any signs of infection.

See Also: Hernia Operation: Recovery After Hernia Surgery

Other Related Conditions

Paraumbilical hernias

Paraumbilical hernias are similar to umbilical hernias. However, in paraumbuilical hernias, the protrusion of abdominal content occurs not through the umbilical ring, but through a weakness in the linea alba , 2cm below or above the umbilicus. The linea alba is simply the white midline of connective tissue that passes through the middle of the abdomen. Paraumbilical hernias are more common in adults, whereas umbilical hernias are most commonly observed in children.

Omphalocele and Gastroschisis

These are two isolated ventral body wall defects that result from two distinctive processes: the first one is the failure of the intestines to return to the abdomen after rotation, and the second one is the failure of the abdominal wall to completely fuse during development. These defects are diagnosed via ultrasound during the intrauterine life; and should be surgically corrected in the first few hours after birth.