Umbilical hernia

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Umbilical hernia
Classification and external resources

Children with umbilical hernias, Sierra Leone (West Africa), 1967.
ICD-10K42
ICD-9551-553
DiseasesDB23647
MedlinePlus000987
MeSHD006554
 
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Umbilical hernia
Classification and external resources

Children with umbilical hernias, Sierra Leone (West Africa), 1967.
ICD-10K42
ICD-9551-553
DiseasesDB23647
MedlinePlus000987
MeSHD006554

Congenital umbilical hernia is a congenital malformation, common in infants of African descent[citation needed]. Among adults, it is three times more common in women than in men; among children, the ratio is roughly equal.[1] An acquired umbilical hernia directly results from increased intra-abdominal pressure caused by obesity, heavy lifting, a long history of coughing, or multiple pregnancies.[2]


Contents

Presentation

A hernia is present at the site of the umbilicus (commonly called a navel, or belly button) in the newborn; although sometimes quite large, these hernias tend to resolve without any treatment by around the age of 2-3 years.[3][citation needed] Obstruction and strangulation of the hernia is rare because the underlying defect in the abdominal wall is larger than in an inguinal hernia of the newborn. The size of the base of the herniated tissue is inversely correlated with risk of strangulation (i.e. narrow base is more likely to strangulate).

Babies are prone to this malformation because of the process during fetal development by which the abdominal organs form outside the abdominal cavity, later returning into it through an opening which will become the umbilicus.

Differential diagnosis

Importantly this type of hernia must be distinguished from a paraumbilical hernia, which occurs in adults and involves a defect in the midline near to the umbilicus, and from omphalocele.

Treatment

When the orifice is small(< 1 or 2 cm), 90% close within 3 years (some sources state 85% of all umbilical hernias, regardless of size[4]), and if these hernias are asymptomatic, reducible, and don't enlarge, no surgery is needed (and in other cases it must be considered). 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. 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 surgeon can opt to stitch the walls of the abdominal or he/she can place mesh over the opening and stitch it to the abdominal walls. 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.[citation needed]

The father of nuclear physics, Ernest Rutherford, died from complications following an operation for umbilical hernia. [5]

See also

References

External links