What is an umbilical hernia?
An umbilical hernia is a protrusion, or abnormal bulge, that can be felt or seen over the belly button. This condition develops when a portion of the intestine protrudes through the muscle of the abdominal wall.
Umbilical hernias in children are caused by an opening in the abdominal wall that is present at birth. The bulge can be seen and felt all the time or only when the child is crying, coughing, or straining during bowel movements. This protrusion may disappear when the child is relaxed.
One in every six children has an umbilical hernia, and it can affect both boys and girls equally. This condition is more common among African-American children than Caucasian children and low birth weight and premature infants have a higher risk of developing umbilical hernias. Umbilical hernias also often occur in adults, and should be repaired if they are causing symptoms of pain or intestinal entrapment.
What are the symptoms of an umbilical hernia?
The most common symptoms associated with umbilical hernia are pain and a bulge. Usually symptoms are stable over time, but often the bulge can become larger or can involve entrapment of internal organs such as intestine. Anyone with a known umbilical hernia who develops persistent nausea and vomiting with severe abdominal pain and inability to pass gas or stool may have intestinal entrapment (incarceration or strangulation) resulting in is a potentially life-threatening situation. This is a medical emergency which requires immediate evaluation; proceed to your nearest emergency room without delay.
What causes an umbilical hernia?
The abdominal organs are formed on the outside of a baby’s body during their development in the womb. These organs return to the abdominal cavity around the 10th week of gestation. If the wall of the abdomen fails to close around the abdominal organs, an umbilical hernia can form.
On occasion, the intestines can become trapped in this muscular defect, which causes umbilical pain and tenderness. This is condition is called an incarcerated hernia and must be evaluated immediately to prevent the cause of damage to the intestines. Symptoms of an incarcerated hernia include severe pain and redness of the bulge.
When should an Umbilical hernia be repaired?
In children, most umbilical hernias will go away on their own by age 3 or 4. This is why it may be recommended to wait until your child has reached this age to consider surgical repair. If, however, the defect is greater than 2cm in diameter, it will need to be surgically repaired. In adults, any symptomatic umbilical hernia should be evaluated for repair.
The Surgical Procedure
If it is determined that your child will need to undergo umbilical hernia repair, a small incision will be made at the base of the belly button where the bulging intestine can be identified. Then the intestine can be pushed back into its proper place, while the hernia sac is removed. Multiple stitches are put in place around the muscle wall to prevent another hernia. The skin around the belly button will be then sewn down and attached to the underlying muscle so that the belly button looks like an “innie” instead of an “outie.” Most children are able to return home within a few hours after surgery, however children with certain medical conditions and premature infants may need to remain under observation for one night.
For adults, the decision to repair an umbilical hernia with mesh depends on the size of the hernia defect found at the time of surgery. The surgeons at Advanced Surgical and Bariatrics of NJ can evaluate you and provide more details at your consultation visit.