Umbilical hernia
Encyclopedia
Congenital umbilical hernia is a congenital malformation, common in infants of African descent. Among adults, it is three times more common in women than in men; among children, the ratio is roughly equal. An acquired umbilical hernia directly results from increased intra-abdominal pressure caused by obesity, heavy lifting, a long history of coughing, or multiple pregnancies.
is present at the site of the umbilicus
(commonly called a navel, or belly button) in the newborn; although sometimes quite large, these hernias tend to resolve without any treatment by around the age of 2-3 years. Obstruction and strangulation of the hernia is rare because the underlying defect in the abdominal wall is larger than in an inguinal hernia
of the newborn. The size of the base of the herniated tissue is inversely correlated with risk of strangulation (i.e. narrow base is more likely to strangulate).
Babies are prone to this malformation because of the process during fetal development
by which the abdominal organs form outside the abdominal cavity, later returning into it through an opening which will become the umbilicus.
, which occurs in adults and involves a defect in the midline near to the umbilicus, and from omphalocele
.
bowel. The use of bandages or other articles to continuously reduce the hernia is not evidence-based.
An umbilical hernia can be fixed 2 different ways. The surgeon can opt to stitch the walls of the abdominal or he/she can place mesh over the opening and stitch it to the abdominal walls. The latter is of a stronger hold and is commonly used for larger tears in the abdominal wall. Most surgeons will repair the hernia 6 weeks after the baby is born.
The father of nuclear physics, Ernest Rutherford
, died from complications following an operation for umbilical hernia.
Presentation
Dr. Karem M. Wasfi: A herniaHernia
A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hiatal hernia occurs when the stomach protrudes into the mediastinum through the esophageal opening in the diaphragm....
is present at the site of the umbilicus
Navel
The navel is a scar on the abdomen caused when the umbilical cord is removed from a newborn baby...
(commonly called a navel, or belly button) in the newborn; although sometimes quite large, these hernias tend to resolve without any treatment by around the age of 2-3 years. Obstruction and strangulation of the hernia is rare because the underlying defect in the abdominal wall is larger than in an inguinal hernia
Inguinal hernia
An inguinal hernia is a protrusion of abdominal-cavity contents through the inguinal canal. They are very common , and their repair is one of the most frequently performed surgical operations....
of the newborn. The size of the base of the herniated tissue is inversely correlated with risk of strangulation (i.e. narrow base is more likely to strangulate).
Babies are prone to this malformation because of the process during fetal development
Fetal development
Prenatal or antenatal development is the process in which a human embryo or fetus gestates during pregnancy, from fertilization until birth. Often, the terms fetal development, foetal development, or embryology are used in a similar sense.After fertilization the embryogenesis starts...
by which the abdominal organs form outside the abdominal cavity, later returning into it through an opening which will become the umbilicus.
Differential diagnosis
Importantly this type of hernia must be distinguished from a paraumbilical herniaParaumbilical hernia
A paraumbilical hernia is a protrusion of the intestines or gut into the abdomen through a weak point of the muscles or ligaments near the navel. It can lead to discomfort when fatty tissue gets trapped and a lump can be felt or seen...
, which occurs in adults and involves a defect in the midline near to the umbilicus, and from omphalocele
Omphalocele
An omphalocele is a type of abdominal wall defect in which the intestines, liver, and occasionally other organs remain outside of the abdomen in a sac because of a defect in the development of the muscles of the abdominal wall.-Presentation:The sac, which is formed from an outpouching of...
.
Treatment
When the orifice is small(< 1 or 2 cm), 90% close within 3 years (some sources state 85% of all umbilical hernias, regardless of size), and if these hernias are asymptomatic, reducible, and don't enlarge, no surgery is needed (and in other cases it must be considered). In some communities mothers routinely push the small bulge back in and tape a coin over the palpable hernia hole until closure occurs. This practice is not medically recommended as there is a small risk of trapping a loop of bowel under part of the coin resulting in a small area of ischemicIschemia
In medicine, ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It may also be spelled ischaemia or ischæmia...
bowel. The use of bandages or other articles to continuously reduce the hernia is not evidence-based.
An umbilical hernia can be fixed 2 different ways. The surgeon can opt to stitch the walls of the abdominal or he/she can place mesh over the opening and stitch it to the abdominal walls. The latter is of a stronger hold and is commonly used for larger tears in the abdominal wall. Most surgeons will repair the hernia 6 weeks after the baby is born.
The father of nuclear physics, Ernest Rutherford
Ernest Rutherford
Ernest Rutherford, 1st Baron Rutherford of Nelson OM, FRS was a New Zealand-born British chemist and physicist who became known as the father of nuclear physics...
, died from complications following an operation for umbilical hernia.
External links
- Overview at Cincinnati Children's Hospital Medical CenterCincinnati Children's Hospital Medical CenterCincinnati Children's Hospital Medical Center is a 523-bed pediatric hospital located in Cincinnati, Ohio. It is currently ranked the third-best pediatric medical center in the United States by US News and World Report...
- Overview at Penn State