What is an umbilical hernia? An umbilical hernia is a protrusion of abdominal organs or parts of them outward through a weak area in the connective tissue around the navel. In some cases, the hernia may be noticeable only when pressure inside the abdominal cavity increases, for example during coughing or lifting heavy objects.
How does an umbilical hernia develop?
During pregnancy, the umbilical cord supplies the embryo with nutrients. It connects to an opening in the abdominal wall, which normally heals after birth, closing the opening. In newborns, this closure sometimes occurs later, and this weak spot can lead to the development of an umbilical hernia. This often happens when intra-abdominal pressure increases, for example due to crying or severe coughing.
Premature infants are at increased risk of developing an umbilical hernia. Umbilical hernias are also found in adults with persistently increased intra-abdominal pressure, for example due to obesity, pregnancy, or ascites.
How is an umbilical hernia diagnosed?
An umbilical hernia can usually be seen externally when the patient is in an upright position. If necessary, the physician attempts to push the contents of the hernia sac back into the abdominal cavity while the patient is lying down. The size of the hernia defect can also be palpated. If the diagnosis is unclear, especially in patients with severe obesity, the physician may use ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI).
How is an umbilical hernia treated?
In children, incarceration of intestinal segments in the hernia sac is extremely rare. Moreover, by the age of one and a half years, an umbilical hernia usually closes on its own. In exceptional cases, an umbilical hernia may decrease in size or close completely by the age of five. For this reason, it is usually only monitored during the first three years of life. However, if incarceration of intestinal segments occurs or if the hernia does not close even after three years, surgical intervention is required.
In adolescents and adults, incarceration of intestinal segments occurs more frequently and can be life-threatening. Therefore, umbilical hernias are generally treated surgically. Only small umbilical hernias that develop during pregnancy often regress after childbirth without further intervention. Operations are usually performed under general anesthesia. At the “Bogolyuby” Medical Center, umbilical hernias can be repaired either by open surgery or laparoscopically.
During laparoscopic umbilical hernia repair, an endoscope is inserted through small incisions in the lateral abdominal wall. Additional instruments are introduced through these incisions to close the hernia. This is a minimally invasive procedure. In addition, a synthetic mesh is implanted into the abdominal wall to provide extra stability.
During open surgery, the hernia sac is pushed back into the abdominal cavity through a small incision in the abdominal wall, after which the edges of the hernia are sutured together, closing the hernia defect. If umbilical hernias recur or if the hernia is very large, a synthetic mesh is also implanted.
What should be expected after surgery?
Mild swelling around the incision and bluish discoloration of the skin are normal. To prevent recurrence of the hernia, lifting heavy objects, bending, and twisting should be avoided for several weeks. Depending on the patient’s condition, the physician will determine when and under what conditions it is possible to return to work. Be sure to contact your doctor if you experience symptoms such as fever, severe abdominal pain, weakness, swelling, bleeding, nausea and/or vomiting, shortness of breath, inability to urinate, or inability to have a bowel movement.
How can the risk of an umbilical hernia be reduced?
Situations that cause high intra-abdominal pressure, such as lifting heavy objects, should be avoided, as this significantly strains the abdominal muscles. In addition, significant excess body weight increases intra-abdominal pressure and, in combination with connective tissue weakness, can lead to an umbilical hernia. Therefore, it is advisable to maintain a healthy body weight through a balanced diet and regular physical activity.
