What is Umbilical Hernia?
When a portion of the intestine bulges through an opening in the abdominal muscles it is known as umbilical hernia. Umbilical hernia is a relatively harmless condition and is commonly seen in many people, especially infants. The umbilical hernia becomes very obvious in an infant when the baby cries which causes protrusion of the baby's bellybutton. This is a characteristic sign of an infant umbilical hernia. In many infants, umbilical hernias close by themselves before they turn 1; although, some may take a bit longer to heal. Surgical repair may be needed to prevent complications if the umbilical hernia doesn't resolve or disappear by age 3. Surgical repair may also be required for umbilical hernias in adults. Both boys and girls are equally affected by this condition. In adults, Umbilical Hernia is more common in women aged 50 to 60 years old.
Causes and Risk Factors of Umbilical Hernia
When the baby is in the mother's womb, the umbilical cord passes through a small opening in the abdominal muscles of the baby. This opening normally closes immediately after birth. If the muscles don't completely unite in the midline of the abdomen, it results in weakness in the abdominal wall, thereby increasing the risk for an umbilical hernia at birth or later on. In grownups, increase in abdominal pressure may cause an umbilical hernia. The likely causes for the increased intra-abdominal pressure are:
- Multiple pregnancies.
- Ascites. (presence of fluid in abdominal cavity)
- Prior abdominal surgery.
Risk Factors for Umbilical Hernia
- Premature babies with low birth weight are at a higher risk for developing umbilical hernias.
- Black infants also tend to have a slightly higher risk for developing umbilical hernias.
- In adults, obesity or multiple pregnancies tends to increase the risk of developing an umbilical hernia. Umbilical hernia is more common in women aged from 50 to 60 years old.
Signs and Symptoms of Umbilical Hernia
- Presence of a soft swelling or bulge near the navel (umbilicus). In babies it is noticeable when the baby cries, coughs or strains and the bulge may disappear when the baby calms down or is lying on his or her back.
- Usually umbilical hernias don't produce pain in children.
- Adults developing umbilical hernias may suffer from abdominal discomfort.
Serious Symptoms of Umbilical Hernia are:
- If the baby is in pain.
- If the baby begins to vomit.
- Tenderness, swelling or discoloration of the hernia or the bulge.
- The same serious symptoms apply for adults too.
Tests to Diagnose Umbilical Hernia
- Physical exam reveals the presence of umbilical hernia.
- Abdominal ultrasound.
- X-ray of the abdomen.
Treatment of Umbilical Hernia
In babies, majority of the umbilical hernias close on their own by the time they are 18 months old. The doctor may also be able to push the protrusion back into the abdomen during a physical exam; however, this should be done by the doctor only and patients should never try this on their own. In adults, surgery is done to avoid complications, particularly if the size of the umbilical hernia gets bigger or if it becomes painful.
Surgery is Done in Children if the Umbilical Hernias are:
- Tender and painful.
- Greater than 1.5 centimeters in width.
- Are not reduced in size after six to 12 months.
- Don't close or disappear by the time they are 3 years old.
- Becomes incarcerated or trapped.
- If the hernia obstructs the intestines.
Complications of an Umbilical Hernia
Complications of an umbilical hernia are rare. Complications often occur when the hernia becomes incarcerated, i.e., the bulging abdominal tissue becomes trapped and cannot be pushed back into the abdominal cavity resulting in diminished blood supply to the trapped region, umbilical pain and tissue damage. In case of strangulated hernia, blood supply to the trapped region of intestine is completely cut off and causes gangrene, i.e. tissue death. This may cause infection to spread throughout the abdominal cavity and can become potentially a life-threatening situation. Adults having umbilical hernia are at higher risk for developing incarceration or obstruction of the intestines. Emergency surgery is usually required for treating these complications.