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 Diseases and Conditions
Umbilical hernia
From MayoClinic.com
Special to CNN.com Introduction Does your baby's bellybutton protrude when he or she cries? Don't be alarmed. This is a classic sign of an umbilical hernia — a common and typically harmless condition. An umbilical hernia occurs when part of the intestine protrudes through a weak spot in the abdominal muscles. Umbilical hernias are most common in infants, but they can affect adults as well. Most umbilical hernias close on their own by age 2. To prevent complications, umbilical hernias that don't disappear by age 4 or 5 or those that appear during adulthood may need to be repaired surgically. Signs and symptoms An umbilical hernia creates a soft swelling or bulge near the navel (umbilicus). The bulge may range from 1 to 5 centimeters in diameter. If your baby has an umbilical hernia, you may notice the bulge only when he or she cries, coughs or strains. The bulge may disappear when your baby is calm or lies on his or her back. Umbilical hernias in children are usually painless. Umbilical hernias that appear during adulthood may cause abdominal discomfort. Causes During pregnancy, the umbilical cord passes through a small opening in the baby's abdominal muscles. The opening normally closes before birth. If the muscles don't grow together completely, this weakness in the abdominal wall may cause an umbilical hernia at birth or later in life. In adults, too much abdominal pressure can cause an umbilical hernia. Possible culprits include:
Risk factors Umbilical hernias are most common in infants — especially premature babies and those with low birth weights. The condition affects boys and girls equally. For adults, being overweight or having multiple pregnancies may increase the risk of developing an umbilical hernia. When to seek medical advice If you suspect that your baby has an umbilical hernia, consult his or her doctor. Seek emergency care if:
Similar guidelines apply to adults. Consult your doctor if you have a bulge near your navel. Seek emergency care if the bulge becomes painful or tender. Prompt diagnosis and treatment can help prevent complications. Screening and diagnosis An umbilical hernia is diagnosed during a physical exam. Sometimes blood tests or imaging studies — such as an abdominal ultrasound or X-ray — are used to screen for complications. Complications For children, complications of an umbilical hernia are rare. In less than 1 percent of cases, the protruding abdominal tissue becomes trapped (incarcerated) and can no longer be pushed back into the abdominal cavity. This reduces the blood supply to the section of trapped intestine and can lead to umbilical pain and tissue damage. Adults are somewhat more likely to experience incarceration or obstruction of the intestines. Emergency surgery is typically required to treat these complications. Treatment Most umbilical hernias close on their own by age 2. The doctor may even be able to push the bulge back into the abdomen during a physical exam. For children, surgery is typically reserved for large or painful umbilical hernias or those that:
For adults, surgery is typically recommended to avoid possible complications — especially if the umbilical hernia gets bigger or becomes painful. During surgery, a small incision is made at the base of the bellybutton. The herniated tissue is returned to the abdominal cavity, and the opening in the abdominal wall is stitched closed. Most people are able to go home within a few hours after surgery and resume typical activities within two to four weeks. Recurrences are unlikely. March 23, 2006 |
