Umbilical Hernia

Outpouching of skin over belly button. A protrusion of the intestine and omentum through a hernia in the abdominal wall near the navel.

Etiology:

Due to weakness in the abdominal muscles.

Risks and Complications:

Obstruction and strangulation of the hernia. This is rare. The size of the base of the herniated tissued is inversely correlated with risk of strangulation, the narrower the base of the hernia, the more prone this region of the intesting is to strangulate, resulting in a region of ischemic bowel.  The underlying defect in the abdominal wall is larger than in an inguinal hernia of the newborn where there is higher risk of tissue ischemia.

Umbilical hernias do occurs as a congenital developmental abnormality During the normal fetal developmental process, the abdominal organs form outside the abdominal cavity, later returning into it through an opening which will become the umbilicus.

Manifestations:

  1. In children is centrally located at the umbilicus = The Congenital Umbilical Hernia
  2. In adults it is usually partially above the umbilicus = The Paraumbilical Hernia

Treatment and Management:

Surgical interventions:

  1. Suture of the abdominal walls
  2. Placement of a reinforing mesh over the affected area, suturing it to the abdominal walls. This method maintains a higher degree of structureal integrity and strength and is therefore used  in the case of larger tears in the abdominal wall.

The congenital umbilical hernias tend to resolve without intervention before the individual reaches the age of five years.

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