Umbilical hernia Open pop-up dialog box Close Umbilical hernia Umbilical hernia An umbilical hernia creates a soft swelling or bulge near the navel. It occurs when part of the intestine protrudes through the umbilical opening in the abdominal muscles. Umbilical hernias in children are usually painless. An umbilical hernia occurs when part of your intestine sticks out through the opening in your abdominal muscles through which your umbilical cord passed before you were born. Umbilical hernias are common and typically harmless. They are most common in infants, but they can affect adults as well.
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Ultrasound showing an incarcerated umbilical hernia  Ultrasound showing an incarcerated umbilical hernia  Children[ edit ] 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 ischemic bowel.
This "fix" does not help and germs may accumulate under the tape, causing infection. The use of bandages or other articles to continuously reduce the hernia is not evidence-based. An umbilical hernia can be fixed in two different ways. The latter is of a stronger hold and is commonly used for larger defects in the abdominal wall.
Most surgeons will not repair the hernia until 5—6 years after the baby is born. Most umbilical hernias in infants and children close spontaneously and rarely have complications of gastrointestinal -content incarcerations. In some, it may be just a small protrusion; in others it may be a large rounded swelling that bulges out when the baby cries.
It may hardly be visible when the child is quiet and or sleeping. Normally, the abdominal muscles converge and fuse at the umbilicus during the formation stage, however, in some cases, there remains a gap where the muscles do not close and through this gap the inner intestines come up and bulge under the skin, giving rise to an umbilical hernia. The bulge and its contents can easily be pushed back and reduced into the abdominal cavity.
Ganesh Kumar K Ammannaya. In contrast to an inguinal hernia , the complication incidence is very low, and in addition, the gap in the muscles usually closes with time and the hernia disappears on its own.
The treatment of this condition is essentially conservative: observation allowing the child to grow up and see if it disappears. Operation and closure of the defect is required only if the hernia persists after the age of 3 years or if the child has an episode of complication during the period of observation like irreducibility, intestinal obstruction , abdominal distension with vomiting , or red shiny painful skin over the swelling.
Surgery is always done under anesthesia. The defect in the muscles is defined and the edges of the muscles are brought together with sutures to close the defect. In general, the child needs to stay in the hospital for 1 day  and the healing is complete within 8 days. It may bleed on touch, or may stain the clothes that come in contact with it.
This needs to be shown to a pediatric surgeon. This is most likely to be an umbilical polyp and the therapy is to tie it at the base with a stitch so that it falls off and there is no bleeding. Alternatively, it may be an umbilical granuloma that responds well to local application of dry salt or silver nitrate but may take a few weeks to heal and dry.
However, because the risk of complications with age are higher and the hernia is unlikely to resolve without treatment, surgery is usually recommended. In some cases, the content gets trapped in the hernia sac, outside the abdominal wall. The blood flow to this trapped tissue may be compromised, or the content even strangulated in some cases. Depending on the severity and duration of blood flow compromise, it can cause some pain and discomfort.
Usually the situation resolves itself, when the protrusion of content is returned to the abdominal cavity. Sometimes this needs to be done by a doctor at the ICU. If so, emergency surgery is often required, since prolonged compromise in blood flow otherwise threatens organ integrity. The surgery is performed under anaesthesia , while the surgeon identifies the edges of the defect and bring them together permanently using either suture or mesh.
The most common complications for both techniques are superficial wound infections, recurrence of the hernia  and some people experience pain from the surgical site.
Eine Hernie kann je nach Lokalisation durch eine Schwellung auffallen oder unbemerkt bleiben. Dies stellt aber keine Heilung dar, und eine planbare Operation Wochen bis Monate ist nicht zu umgehen. Solange keine Brucheinklemmung oder andere Komplikationen auftreten, besteht kein Anlass zu einer sofortigen Operation. Solche Wunden bewirken wegen der damit verbundenen Steigerung des Operationsinfektionsrisikos oft einen weiteren Aufschub der unvermeidbar notwendigen Operation. Eine Operation ist damit nicht unbedingt notwendig. Da nur eine Operation einen bleibenden Erfolg sichert, ist sie heute die Regel. Wegen der Gefahr einer lebensbedrohenden Inkarzeration s.
Complications An umbilical hernia occurs when part of the bowel or fatty tissue pokes through an area near the belly button, pushing through a weak spot in the surrounding abdominal wall. There are different types of hernia. According to an article in The BMJ, a true umbilical hernia happens when there is a defect in the anterior abdominal wall that underlies the umbilicus, or navel. They are common in newborns and infants, but they can affect adults, too.