Umbilical Hernia

What is umbilical hernia?

Umbilical hernia is a bulge that forms near the navel or belly button, when a part of the intestine, fat or fluid is pushed out through a weakened muscle of the abdomen. It is commonly found in infants and young children, especially in premature babies. The umbilical cord passes through a small muscular opening in the baby’s abdomen during pregnancy. Sometimes, the muscles of the umbilical opening fail to close completely after birth. This leads to a weak spot near the navel, which allows internal organs of the abdomen to push through it.

In adults, umbilical hernias are more often acquired and are associated with increased intra-abdominal pressure due to obesity, abdominal distension, ascites, and pregnancy. They occur more commonly in females than in males.

What are the signs & symptoms of umbilical hernia?

Umbilical hernias may manifest as a bulge and can be associated with some discomfort. The bulge may get larger on coughing or straining. Large hernias may cause pain when you exert pressure, while standing up or lifting heavy objects.

If you experience severe abdominal pain or the lump is reddish and tender, there may be a chance your intestine is obstructed (stuck in the hernia) or strangulated. Strangulation may block blood flow to the part of your intestine that is stuck and cause tissue necrosis (death of tissue) which may endanger your life. A trapped or obstructed umbilical hernia may cause the following symptoms:

• Umbilical pain
• Nausea or vomiting
• Abdominal pain

Presence of these symptoms requires an emergency hernia repair to release the trapped tissue.

How is umbilical hernia diagnosed?

Physical examination is the first line of diagnosis to test for an umbilical hernia. The bulge at the umbilicus will be examined for its texture, size and protrusion. If the hernia cannot be detected with physical examination, your doctor may order other tests such as an ultrasound of the abdomen or groin.

What are the treatment options for umbilical hernia?

Umbilical hernia usually requires surgical repair. Your surgeon will push the bulged organ back to its place and close or provide support to the weakened area of the abdominal cavity.

Your surgeon may perform either an open or a laparoscopic surgery to repair the hernia. These procedures will be performed under the effect of general anaesthesia.

Open surgery

During the procedure, a single 3 to 4 cm long incision will be made over the bulge and the hernia will be separated from the surrounding tissues. Your surgeon may remove any excess tissue if required. The part of your protruded peritoneal sac will be pushed back into the abdomen. The muscles of the weak abdominal wall may either be stitched or a piece of mesh may be sutured in place to strengthen it.

Laparoscopic surgery

During laparoscopy, your surgeon will make 3 small incisions on the abdominal wall. A laparoscope (thin tube with a lighted device and a camera on its end) is inserted through one of the incisions and special surgical instruments are placed in through the other incisions. The peritoneal sac is pushed back in place and muscles of the abdominal wall are repaired using a synthetic mesh.