In an infant, an umbilical hernia arises because the fibrous ring of the navel has not closed and in an adult because of an increase in intra-abdominal pressure.
An infant umbilical hernia usually disappears spontaneously when the child is between two and three years old, only being treated if it persists after four years, or if the hernia happens to be too large. In adults, this type of hernia is more common in females, especially those who are obese or who have had several children, although it arises with some frequency in cirrhotic patients with ascites.
The diagnosis is evident from the presence of a swelling or sinew protrusion that can be exacerbated by actions that increase the intra-abdominal volume such as coughing, lifting or raising of the head or legs. If the hernia is not obvious, an ultrasound or a CT scan can assist in diagnosis.
Smaller hernias are asymptomatic but discomfort and swelling are the most common manifestations. The hernia is usually painful because of the pressure it places on the surrounding tissues as it increases in size.
Treatment of any umbilical hernia should be surgical because of the high risk of strangulation. The precise technique used depends on hernia size.
A conservative approach should be adopted in patients with significant co-morbidities, the incision size depending on hernia size. During the procedure, the sac and the defective aponeurosis are isolated. The sac contents are either then removed or reduced depending on feasibility. For small hernias (less than 2 cm), aponeurosis closure is achieved by suturing in the direction of the lower sinew.
Prevention of complications such as choking or strangulation.
Major complications of abdominal hernias are imprisonment (parts of the abdominal structure forced out of the abdominal cavity) and strangulation (constriction of the intestine or other structure within the sac, due to compression of blood vessels, with consequent reduction or cutting off of the bloodstream). Seroma, hematoma and infection may also occur.
Refrain, temporally, from physical activities.
