Umbilical Hernia

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Definition :
An umbilical hernia is an outward bulging (protrusion) of the abdominal lining or part of the abdominal organ(s) through the area around the belly button

 

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An umbilical hernia is a protrusion of the peritoneum and fluid, omentum, or a portion of abdominal organ(s) through the umbilical ring. The umbilical ring is the fibrous and muscle tissue around the navel (belly-button). Small hernias usually close spontaneously without treatment by age 1 or 2. Umbilical hernias are usually painless and are common in infants.

UMBILICAL Hernias, and nearby hernias called “Paraumbilical Hernias” develop in and around the area of the umbilicus (belly button or navel). A Congenital (present since birth) weakness in the naval area exists. This was the area at which the vessels of the fetal and infant umbilical cord exited through the muscle of the abdominal wall. After birth, although the umbilical cord disappears (leaving just the dimpled belly-button scar), the weakness underneath may persist. Hernias can occur in this area of weakness at any time from birth through late adulthood. The signs and symptoms include pain at or near the navel area as well as the development of an associated bulge or navel deformity. This bulge pushes out upon the skin beneath or around the navel, distorting the normal contour and architecture in or around the navel (creating an ‘OUTIE’ instead of a normal ‘INNIE‘).
Although often appearing at or just after birth, these hernias can also occur at any time during later life. In INFANTS, these hernias may gradually close by age 3 or 4 and surgery can often be delayed until then, unless the hernias are causing problems or enlarging. This decision should be made after examination by a Pediatrician or skilled Surgeon. In ADULTS however, umbilical hernias cannot “heal”, and do gradually increase in size and often become problematic. Incarceration or Strangulation may occur….CLICK & SEE

Umbilical hernia is a congenital malformation, especially common in infants of African descent, and more frequent in boys. An Acquired umbilical hernia directly results from increased intra-abdominal pressure and are most commonly seen in obese individuals.

Causes:

Children:
Umbilical hernias are fairly common. Such a hernia is obvious at birth, as it pushes the belly button outward. This is more obvious when the infant cries, becauses increased pressure results in more noticable bulging.

In infants, the defect is not usually treated surgically. In most cases, by age 3 the umbilical hernia shrinks and closes without treatment.

Umbilical hernia repair may be necessary for children for the following reasons:

*The herniated tissue is stuck in the protruding position, or if blood supply is affected
*The defect has not closed by age 3 or 4
*The defect is very large or unacceptable to parents for cosmetic reasons
*An umbilical hernia in an infant occurs when the muscle through which blood vessels pass to feed the developing fetus doesn’t close completely.

Adults:
Umbilical or para-umbilical hernias are relatively common in adults. They are more common in overweight people and in women, especially after pregnancy. Most surgeons recommend they be surgically repaired, as they tend to get bigger ov

Without surgery, there is a risk that some abdominal contents, typically a bit of fat or intestine, will get stuck (incarcerated) in the hernia defect and become impossible to push back in, which is typically painful. If the blood supply is compromised (strangulation), urgent surgery is needed.

Incarcerated abdominal tissue may cause nausea, vomiting, and abdominal distension.

Any patient with a hernia that cannot be reduced, or pushed back in, while lying down and relaxed should seek urgent medical attention.

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Symptoms
A hernia can vary in width from less than 1 centimeter to more than 5 centimeters.

There is a soft swelling over the belly button that often bulges when the baby sits up, cries, or strains. The bulge may be flat when the infant lies on the back and is quiet.

Risks Factors:
Risks for any anesthesia include the following:
*Strangulation of bowel tissue is rare but serious, and needs immediate surgery.
*Reactions to medications
*Breathing problems, pneumonia
*Heart problems

Risks for any surgery include the following:
*Bleeding
*Infection
*Risks specific to umbilical hernia surgery include injury to bowel, which is rare.

Diagnosis:
The doctor can find the hernia during a physical exam.

Treatment
Usually, no treatment is needed unless the hernia continues past age 3 or 4. In very rare cases, bowel or other tissue can bulge out and lose its blood supply (become strangulated). This is an emergency needing surgery.

Most umbilical hernia repairs are done on an outpatient basis, but some may require a short hospital stay if the hernia is very large. After surgery, the patient’s vital signs are monitored and he or she will remain in the recovery area until stable. Medication is supplied for pain as necessary. Patients, or parents if the patient is a child, are taught to care for the incision at home. Full activity can be resumed in 2-4 weeks.

Prognosis:

Most umbilical hernias get better without treatment by the time the child is 3 – 4 years old. Those that do not close may need surgery. Umbilical hernias are usually painless.

Expect successful repair of the hernia. The long-term prognosis is excellent. Very rarely the hernia will recur. Recurrence is more common if a larger hernia (more than 3 cm) is repaired without a mesh.

Recovery
Most umbilical hernia repairs are done on an outpatient basis, but some may require a short hospital stay if the hernia is very large.

After surgery, the health care team will monitor the patient’s vital signs. The patient will stay in the recovery area until stable. Pain medication is prescribed as needed.

Patients, or parents if the patient is a child, are taught to care for the surgical cut at home. Full activity can be resumed in 2-4 weeks.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://hernia.tripod.com/types.html
http://www.nlm.nih.gov/medlineplus/ency/article/000987.htm
http://www.nlm.nih.gov/medlineplus/ency/article/002935.htm
http://en.wikipedia.org/wiki/Umbilical_hernia

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