Umbilical Hernia

What is an Umbilical hernia?

An umbilical cord is a tube which connects a mother and her foetus in her womb. In mothers, the umbilical cord passes through her placenta in the womb. In babies, the umbilical cord passes through a small opening in their abdominal muscles. Usually, this hole closes right after birth or may be resolved when the baby is three to four years old. An umbilical hernia occurs when the abdominal muscles do not completely join and the baby’s intestine or other tissues bulge through this weak spot near the belly button or navel. One in five babies are born with an umbilical hernia, but if the hernia does not resolve when the baby reaches four years of age, treatment may be required.

Umbilical hernias may also develop in adults and are much more common in women. This is particularly so if an adult is very overweight, lifts heavy objects, or has a persistent cough. Women who have had multiple children are at a higher risk of developing an umbilical hernia.

Treatment is needed to resolve umbilical hernia in many cases, especially in adults.

What increases your risk of an umbilical hernia?

Umbilical hernias are very common in babies. Babies born at a low birth weight and premature risk have a higher risk of developing an umbilical hernia.

In adults, an umbilical hernia occurs when excessive pressure is placed on a weak section of your abdominal muscles. These include being overweight or obese, having multiple pregnancies, having a persistent cough and previously undergone stomach surgery.

How can I tell if I have an umbilical hernia?

A common tell tale sign is a soft bulge or swelling near the navel of your baby. The umbilical hernia becomes more noticeable when your baby is laughing, crying, coughing or straining.

If you are an adult, you may experience pain or discomfort if the hernia- a bulge or swelling near the navel-gets large. Other symptoms you should take note of are

  • The bulge grows bigger in size till at least 1.25cm
  • The bulge becomes dark and discoloured
  • Vomiting
  • Inability to reduce the hernia by flattening the bulge against your abdomen without significant pain and tenderness as you could before

How is umbilical hernia diagnosed?

During a consultation session, your doctor will be able to diagnose an umbilical hernia during a physical examination. The doctor will check if your hernia can be pushed back into your abdominal cavity. It may also be possible to find out if the umbilical cord is trapped or incarcerated. This is a serious complication as the part of your intestine which is trapped may not have sufficient supply of blood.

Should you need further tests to screen for complications, you may be scheduled for an X-ray, abdominal ultrasound or blood tests to check for infection.

Why surgery for umbilical hernia?

Surgery works by pushing the bulge back in place and strengthening the weakened abdominal wall tissue.

Surgery is usually recommended in adults to prevent potential complications that might occur. This includes part of the intestine being stuck in the hernia (incarceration) which may cut off blood supply to intestines (strangulation). It may cause pain and kill off the tissue (gangrene) and there may be a dangerous infection leaving your intestines unable to function. If this happens, emergency surgery may be required.

Umbilical hernias usually resolve on their own the babies and children, and surgery may be required if the hernia persists beyond four years of age. If the umbilical hernia causes pain, is too large or becomes trapped and blocks the intestines, doctors will then choose surgery.

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