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Umbilical Hernia - Causes, Symptoms, Diagnosis, and Treatment

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Umbilical Hernia - Causes, Symptoms, Diagnosis, and Treatment

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An umbilical hernia is common in which a part of the intestine protrudes near the umbilicus (navel button). Read the article to know more.

Written by

Dr. Anahita Ali

Medically reviewed by

Dr. Shivpal Saini

Published At February 16, 2023
Reviewed AtApril 26, 2023

Introduction

An umbilical hernia is a type of hernia that most commonly occurs in infants and goes away by the age of five years. However, 90 percent of adults have acquired umbilical hernia, while ten percent of adults have it in childhood. Only two percent of adults suffer from this condition.

The causes of umbilical hernia are based on increased abdominal pressure. This is why it is more commonly seen in women during pregnancy. Other conditions include obesity or increased weight, extensive physical activity, etc. It can be symptomatic or asymptomatic. In general, elective surgery is recommended for hernia repair.

What Is Umbilical Hernia?

It is a condition in which a part of the intestine bulges out near the umbilicus (belly button). It commonly occurs in newborn babies and naturally heals by the age of five years. It is located three centimeters above or below the umbilicus. It looks like a lump in the umbilical region. The size may vary from small to large - one centimeter to three centimeters and above. When the fatty tissue or fat-containing intestinal part bulges or is pushed outwards, it is called a fat-containing umbilical hernia. It is also noted in pregnant women because of the increased pressure on the abdomen. It occurs during the second trimester in most pregnant women. People with an umbilical hernia should avoid fatty foods containing saturated or trans fats, such as red meat, high-fat dairy products, processed foods, hydrogenated oil, etc.

What Causes Umbilical Hernia?

In newborn babies, when the umbilical cord is of no use after birth, it appears as a small opening in the stomach that closes and heals on its own with time. However, sometimes, the opening does not close properly, and a small hole remains in the umbilicus. In this hole, the intestine penetrates and causes a hernia.

The other common causes in adults are:

  • Long-standing conditions increase the pressure of the stomach.

  • Long-standing cough.

  • Constipation.

  • Enlarged prostate.

  • Vomiting.

  • Obesity.

  • Muscle strain due to weight lifting.

What Are the Umbilical Hernia Symptoms?

  • It appears as a protruded or bulged-out belly button.

  • In newborns, it is visible when they cry.

  • Pain may or may not be present. Generally, it is painless in newborns.

  • Discomfort in adults is seen.

  • Tenderness.

  • Constipation.

  • Fever.

  • The round appearance of the abdomen.

How to Diagnose Umbilical Hernia?

  • Physical Examination: The doctor physically touches and feels the bulge.

  • Medical History: The doctor may ask general questions about the other possible causes such as medical conditions, pregnancy, trimester, etc.

  • Umbilical Hernia Ultrasound: Imaging tests such as ultrasound are required to diagnose complications.

  • Other Imaging Tests: X-ray, magnetic resonance imaging, and computed tomography may be done.

How to Treat Umbilical Hernia?

The treatment depends upon various factors such as the patient's age, symptoms, causes, etc. In general, if the umbilical hernia does not disappear with time and cannot be pushed inside, or if it grows in size or constricts, then surgery may be done as mentioned below:

  • General anesthesia is given to the patient.

  • A small cut or incision is made in the umbilicus.

  • The portion of the intestine that is protruded out is pushed back into the abdominal cavity.

  • The incision is closed with sutures.

The specific surgical approaches are mentioned below.

Repairing With Suture and Mesh-Mesh Repair Surgery:

If the defect is smaller than two centimeters, then firstly, repairing is done through a simple suture technique, as mentioned above. Then mesh repair is done through the open or laparoscopic methods. A mesh acts as a flexible scaffold and prevents internal organs from coming out by reinforcing the muscles. The mesh is placed on the top of the hernia and is held through surgical glue or sutures. The mesh remains permanently within the patient's body for a lifetime. The mesh can be placed through two methods:

Laparoscopic Surgery: Laparoscopic repair surgery is the most effective and safe method for an umbilical hernia. It is a less invasive method; done under general anesthesia; healing is fast, within one to two weeks. The surgery is done through a small opening, and the mesh is placed inside. This surgery can be done via two techniques:

  1. Transabdominal Preperitoneal Approach (TAPP): In this technique, the doctor or surgeon makes an incision five centimeters away from the defect and creates peritoneal space. They then enter the deepest or innermost layer of the abdominal wall. Mesh is then placed and overlapped with a minimum of five centimeters from all sides so that it does not come in contact with other organs. The peritoneal flap is then closed through a suture.

  2. Intraperitoneal Onlay Mesh (IOPM): After performing the simple repair, the mesh is placed with a five centimeters broad overlap. It is an easier and faster technique.

Open Surgery: It is a traditional method; done under general anesthesia, and recovery time is long, up to three weeks.

In general, the healing after surgery occurs in two weeks. After that, the patient can perform normal activities such as walking. However, heavy exercises and activities must be avoided for four to six weeks. Complications after surgery are less; however, some complications include infection, hematoma at the surgical site, and bowel injury.

How to Prevent Umbilical Hernia?

  • Physical activities and exercises such as weight lifting that exert pressure on the abdomen must be avoided.

  • Avoid foods that cause constipation.

  • Maintain body weight.

What Are the Complications of Umbilical Hernia?

Complications occurring due to an umbilical hernia are rare. However, when the protruding abdominal tissue gets trapped and cannot be put back into the abdominal cavity, the blood supply to the trapped section of the intestine is reduced, leading to severe abdominal pain and tissue damage. Life-threatening severe complications can occur when the trapped intestinal portion is completely cut off from the blood supply resulting in tissue death and causing Infection to spread throughout the abdominal cavity.

Conclusion

An umbilical hernia is a common, treatable condition. Surgery is the best-recommended option for all patients to reduce the risks and complications. Laparoscopic repair surgery is the most effective and safe technique. The patient recovers in two to three weeks and can perform daily activities. Fatty foods containing saturated or trans fats should be avoided to prevent umbilical hernia.

Dr. Shivpal Saini
Dr. Shivpal Saini

General Surgery

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