Umbilical Hernia
Also known as . . . belly button hernia
What is it?
An umbilical hernia is a condition in which a defect or hole exists in
the abdominal wall at the level of the umbilicus (belly button). Skin
overlies the defect and bulges especially during straining. During fetal
development, the region of the umbilicus is very important. It is the
point where the structures that make up the umbilical cord pass. This
defect usually closes shortly after birth through natural processes.
Occasionally the process of closure does not finish, and there is a
persistent defect in the abdominal wall, or an umbilical hernia. Even if
an umbilical hernia is present in infancy, most (90%) will close within
the first year or two of life A few will persist into early childhood,
prompting surgical referral.
Diagnosis and Treatment of Umbilical Hernia
The diagnosis of an umbilical hernia is made by history and physical
exam. Children have an intermittent bulge at their umbilicus. Physical
examination will reveal a defect of varying size in the abdominal wall
(fascia). In some cases, the skin changes will be quite dramatic, with a
large amount of stretching of the umbilical skin, creating an almost
(elephant’s) trunk-like appearance to the belly button. Parents are
often surprised to learn that the actual defect is quite small when there
is so much protrusion of the skin.
In contrast to inguinal hernias, which have a
relatively high risk of incarceration (something stuck in the hernia),
umbilical hernias rarely become incarcerated. Repair of an umbilical
hernia is therefore never urgent; however, a defect that is not improving
will usually be repaired sometime before children reach school age.
Surgery is performed as an outpatient, by means of a small incision at the
bottom of the umbilicus. Several sutures (stitches) are placed to close
the hole. Sometimes, excessively redundant skin is removed to enhance the
cosmetic appearance of the umbilicus. Dissolvable sutures are used to
close the skin. Children leave the hospital within several hours of the
procedure. Recovery is usually prompt. Physicians in the Division of
Pediatric Surgery at Penn State Children’s Hospital treat infants,
children, and adolescents with umbilical hernias. We have a team of
surgeons, anesthesiologists, nurses and child life specialists dedicated
to providing both you and your child with the best operative experience
possible. We believe it is important to reduce pre-operative anxiety and
to control post-operative pain and discomfort.
Glossary of Terms
Umbilicus: the "belly button" the scarred remnant of
the site where the umbilical cord was attached
Umbilical cord: the structure through which nutrients are
delivered to the developing infant
Fascia: the tough connective tissue that gives strength to the
abdominal wall
Incarceration: a condition in which abdominal contents become
trapped in a hernia defect
Physicians Who Treat Umbilical Hernias
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
|
