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Umbilical Hernia Symptoms and Treatment
Umbilical Hernia Symptoms and Treatment
Published: 2014/07/21
Channel: Howard County General Hospital
Umbilical Hernia - Everything You Need To Know!
Umbilical Hernia - Everything You Need To Know!
Published: 2017/08/24
Channel: Buck Parker, M.D.
Umbilical Hernia - repair using mesh
Umbilical Hernia - repair using mesh
Published: 2015/03/29
Channel: Online Medical – Website Design & Development for Healthcare Professionals
UCMC ClearMesh Composite - Umbilical Hernia Repair
UCMC ClearMesh Composite - Umbilical Hernia Repair
Published: 2014/11/08
Channel: DIPROMED SRL
Umbilical hernia repair (local anaesthesia)
Umbilical hernia repair (local anaesthesia)
Published: 2016/11/13
Channel: BSAWS Belgian Section for Abdominal Wall Surgery
My Umbilical Hernia Repair Surgery and Recovery
My Umbilical Hernia Repair Surgery and Recovery
Published: 2016/11/05
Channel: Sean Symons
Hernia repair surgery- umbilical hernia
Hernia repair surgery- umbilical hernia
Published: 2013/05/20
Channel: Carolina Surgical
Umbilical Hernia
Umbilical Hernia
Published: 2014/11/05
Channel: Manish Bhalla
UMBILICAL HERNIA SURGERY || UPDATE AND PICTURES
UMBILICAL HERNIA SURGERY || UPDATE AND PICTURES
Published: 2017/10/27
Channel: Time For T
Hernia Around Umbilicus (Umbilical Hernia) In An Elderly Lady
Hernia Around Umbilicus (Umbilical Hernia) In An Elderly Lady
Published: 2012/04/28
Channel: sankaqm5
What is an Umbilical Hernia
What is an Umbilical Hernia
Published: 2016/02/18
Channel: FitnessFashionista
Umbilical hernia repair
Umbilical hernia repair
Published: 2016/01/16
Channel: SURGERY MEDICINE
VENTRAL PATCH EN REPARACIÓN DE HERNIA UMBILICAL
VENTRAL PATCH EN REPARACIÓN DE HERNIA UMBILICAL
Published: 2016/04/22
Channel: Rafael Reyes Richa
open umbilical hernia repair
open umbilical hernia repair
Published: 2016/03/12
Channel: Michigan Hernia Surgery
Laparascopic Incisional or Umbilical Hernia Surgery Patient Information in English
Laparascopic Incisional or Umbilical Hernia Surgery Patient Information in English
Published: 2016/10/25
Channel: Dr Chirag Thakkar
How to Cure an Abdominal Hernia | Cure a Umbilical Hernia Naturally | Weight loss
How to Cure an Abdominal Hernia | Cure a Umbilical Hernia Naturally | Weight loss
Published: 2017/04/01
Channel: Healthy Primix
3 Signs You May have an Umbilical Hernia
3 Signs You May have an Umbilical Hernia
Published: 2016/07/26
Channel: Mary Paulina
Laparoscopic Repair of Umbilical Hernia HD Video
Laparoscopic Repair of Umbilical Hernia HD Video
Published: 2014/09/29
Channel: DR RK Mishra
How to deal with Diastasis Recti and an umbilical hernia while pregnant
How to deal with Diastasis Recti and an umbilical hernia while pregnant
Published: 2016/04/27
Channel: FitnessFashionista
How to Cure Hernia Naturally Without Surgery in Men and Women
How to Cure Hernia Naturally Without Surgery in Men and Women
Published: 2015/12/28
Channel: HD MAX TV
Umbilical Hernia in Cirrhosis
Umbilical Hernia in Cirrhosis
Published: 2014/05/01
Channel: Dr. Joe Galati
Hernia Surgery Recovery First Week - What to expect
Hernia Surgery Recovery First Week - What to expect
Published: 2017/03/14
Channel: Tony Stepanek
How to Cure Hernia Without Surgery - Hernia Treatment Natural without surgery-Best Hernia Exercises
How to Cure Hernia Without Surgery - Hernia Treatment Natural without surgery-Best Hernia Exercises
Published: 2017/04/13
Channel: HEALTH & WELLNESS
Laparoscopic Umbilical Hernia Repair
Laparoscopic Umbilical Hernia Repair
Published: 2009/02/27
Channel: drvalsamidis
umbilical hernia test
umbilical hernia test
Published: 2012/09/24
Channel: kalashhd200
7 Natural Cures For Umbilical Hernia
7 Natural Cures For Umbilical Hernia
Published: 2014/08/02
Channel: Find Home Remedy
3 Yoga Pose for Umbilical Hernia
3 Yoga Pose for Umbilical Hernia
Published: 2017/10/03
Channel: A to Z Cure
6-minutes laparoscopic surgery for umbilical hernia. What is better?
6-minutes laparoscopic surgery for umbilical hernia. What is better?
Published: 2014/01/28
Channel: Nikolay Matveev
Umbilical Hernia Symptoms and Surgical Repair, Dr. Hadley Wesson
Umbilical Hernia Symptoms and Surgical Repair, Dr. Hadley Wesson
Published: 2015/11/24
Channel: Howard County General Hospital
My top tips for dealing with umbilical hernia surgery
My top tips for dealing with umbilical hernia surgery
Published: 2015/04/12
Channel: Chris Hamilton
My Umbilical Hernia & Diastasis Recti
My Umbilical Hernia & Diastasis Recti
Published: 2012/06/27
Channel: JesssFam
Belly Button Hernia
Belly Button Hernia
Published: 2016/06/11
Channel: Family Pediatrics
Umbilical Hernia Repair Surgery Pt 1
Umbilical Hernia Repair Surgery Pt 1
Published: 2016/07/14
Channel: Bobby Sox
Umbilical Hernias in Adults
Umbilical Hernias in Adults
Published: 2016/11/16
Channel: Lee Health Marketing
IRREDUCIBLE Umbilical Hernia
IRREDUCIBLE Umbilical Hernia
Published: 2012/02/04
Channel: sankaqm5
Pregnant woman with umbilical hernia shows off belly button trick
Pregnant woman with umbilical hernia shows off belly button trick
Published: 2016/06/07
Channel: all around the web
How to get in and out of bed after an umbilical hernia open mesh repair. Video 5
How to get in and out of bed after an umbilical hernia open mesh repair. Video 5
Published: 2015/04/04
Channel: Chris Hamilton
Para-Umbilical Hernia
Para-Umbilical Hernia
Published: 2014/06/29
Channel: Dr Praveen Choudhary
Umbilical Hernia | Radiology | TheNP
Umbilical Hernia | Radiology | TheNP
Published: 2016/08/13
Channel: TheNP
Laparoscopic Umbilical Hernia Repair (Lap Surgical Technique)
Laparoscopic Umbilical Hernia Repair (Lap Surgical Technique)
Published: 2017/06/18
Channel: MedFreelancers
Umbilical Hernia: Causes, Symptoms, Diagnosis, and Treatment
Umbilical Hernia: Causes, Symptoms, Diagnosis, and Treatment
Published: 2015/11/10
Channel: Hernia Center of Southern California
Herniorrafia  umbilical / Umbilical hernia repair
Herniorrafia umbilical / Umbilical hernia repair
Published: 2014/08/28
Channel: Dr. Virgilio Dourado
Hernia of the umbilical cord
Hernia of the umbilical cord
Published: 2017/05/05
Channel: Maher AL Zaiem
After Umbilical Hernia Repair Surgery
After Umbilical Hernia Repair Surgery
Published: 2012/04/13
Channel: TX2LA
Umbilical hernia repair. Laparoscopic,  "unedited" by  Prof Yerdel
Umbilical hernia repair. Laparoscopic, "unedited" by Prof Yerdel
Published: 2013/07/28
Channel: mehmet ali yerdel
Umbilical Hernia Surgery | Vlog |2017
Umbilical Hernia Surgery | Vlog |2017
Published: 2017/09/05
Channel: Terlyn Parks
Umbilical hernia  -  Mayo
Umbilical hernia - Mayo's repair
Published: 2017/05/11
Channel: Sukumar Maiti
Laparoscopic Umbilical Hernia Repair with Mesh
Laparoscopic Umbilical Hernia Repair with Mesh
Published: 2016/04/29
Channel: Dr.Abdul Kader Weiss
Cirugia de hernia umbilical
Cirugia de hernia umbilical
Published: 2016/11/09
Channel: miguel angel rojas vasquez
Kinesio Taping Umbilical Hernia and Diastasis Recti during Pregnancy
Kinesio Taping Umbilical Hernia and Diastasis Recti during Pregnancy
Published: 2017/03/31
Channel: Strength Therapy
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WIKIPEDIA ARTICLE

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Umbilical hernia
Children with umbilical hernias, Sierra Leone (West Africa), 1967.jpg
Children with umbilical hernias, Sierra Leone (West Africa), 1967.
Classification and external resources
Specialty gastroenterology
ICD-10 K42
ICD-9-CM 551-553
DiseasesDB 23647
MedlinePlus 000987
MeSH D006554

An umbilical hernia is a health condition where the abdominal wall behind the navel is damaged. It may cause the navel to bulge outwards—the bulge consisting of abdominal fat from the greater omentum or occasionally parts of the small intestine. The bulge can often be pressed back through the hole in the abdominal wall, and may "pop out" when coughing or otherwise acting to increase intra-abdominal pressure. Treatment is surgical, and surgery may be performed for cosmetic as well as health-related reasons.

Signs and symptoms[edit]

A hernia is present at the site of the umbilicus (commonly called a navel or belly button) in newborns; although sometimes quite large, these hernias tend to resolve without any treatment by around the age of 2–3 years.[1][citation needed] Obstruction and strangulation of the hernia is rare because the underlying defect in the abdominal wall is larger than in an inguinal hernia of the newborn. The size of the base of the herniated tissue is inversely correlated with risk of strangulation (i.e., a narrow base is more likely to strangulate).

Babies are prone to this malformation because of the process during fetal development by which the abdominal organs form outside the abdominal cavity, later returning into it through an opening which will become the umbilicus.

Hernias may be asymptomatic and present only as a bulge of the umbilicus. Symptoms may develop when the contracting abdominal wall causes pressure on the hernia contents. This results in abdominal pain or discomfort. These symptoms may be worsened by the patient lifting or straining.

Causes[edit]

In more severe cases of umbilical hernias, the small intestine can poke out through the opening. This can very rarely cause ischemia and necrosis of the intestine and is potentially life-threatening. The bulge is often caused by fat or parts of the greater omentum.

The causes of umbilical hernia are congenital and acquired malformation, but an apparent third cause is really a cause of a different type, a paraumbilical hernia.

Congenital[edit]

Congenital umbilical hernia is a congenital malformation of the navel (umbilicus). Among adults, it is three times more common in women than in men; among children, the ratio is roughly equal.[2] It is also found to be more common in children of African descent.[3][4][5]

Acquired[edit]

An acquired umbilical hernia directly results from increased intra-abdominal pressure caused by obesity, heavy lifting, a long history of coughing, or multiple pregnancies.[6][7] Another type of aquired umbilical hernias are incisional hernias, which are hernia developing in a scar following abdominal surgery, e.g. after insertion of laparoscopy trocars through the umbilicus.

Paraumbilical[edit]

Importantly, an umbilical hernia must be distinguished from a paraumbilical hernia, which occurs in adults and involves a defect in the midline near to the umbilicus, and from omphalocele.[citation needed]

Diagnosis[edit]

Navels with the umbilical tip protruding past the umbilical skin ("outies") are often mistaken for umbilical hernias, which are a completely different shape. Treatment for cosmetic purposes is not necessary, unless there are health concerns such as pain, discofort or incarceration of the hernia content.[clarification needed] Incarceration refers to the inability to reduce the hernia back into the abdominal cavity. Prolonged incarceration can lead to tissue ischemia (strangulation) and shock when untreated.

Umbilical hernias are rare. With a study involving Africans, 92% of children had protrusions, 49% of adults, and 90% of pregnant women. However, a much smaller amount actually suffered from hernias: only 23% of children, 8% of adults, and 15% of pregnant women.[3]

When the orifice is small (< 1 or 2 cm), 90% close within 3 years (some sources state 85% of all umbilical hernias, regardless of size), and if these hernias are asymptomatic, reducible, and don't enlarge, no surgery is needed (and in other cases it must be considered).

Treatment of children[edit]

In some communities mothers routinely push the small bulge back in and tape a coin over the palpable hernia hole until closure occurs. This practice is not medically recommended as there is a small risk of trapping a loop of bowel under part of the coin resulting in a small area of ischemic bowel. This "fix" does not help and germs may accumulate under the tape, causing infection. The use of bandages or other articles to continuously reduce the hernia is not evidence-based.

An umbilical hernia can be fixed in two different ways. The surgeon can opt to stitch the walls of the abdominal or he/she can place mesh over the opening and stitch it to the abdominal walls. The latter is of a stronger hold and is commonly used for larger defects in the abdominal wall. Most surgeons will not repair the hernia until 5–6 years after the baby is born. Most umbilical hernias in infants and children close spontaneously and rarely have complications of gastrointestinal-content incarcerations.[9]

How far the projection of the swelling extends from the surface of the abdomen (the belly) varies from child to child. In some, it may be just a small protrusion; in others it may be a large rounded swelling that bulges out when the baby cries. It may hardly be visible when the child is quiet and or sleeping.

Normally, the abdominal muscles converge and fuse at the umbilicus during the formation stage, however, in some cases, there remains a gap where the muscles do not close and through this gap the inner intestines come up and bulge under the skin, giving rise to an umbilical hernia. The bulge and its contents can easily be pushed back and reduced into the abdominal cavity.[citation needed]

In contrast to an inguinal hernia, the complication incidence is very low, and in addition, the gap in the muscles usually closes with time and the hernia disappears on its own. The treatment of this condition is essentially conservative: observation allowing the child to grow up and see if it disappears. Operation and closure of the defect is required only if the hernia persists after the age of 3 years or if the child has an episode of complication during the period of observation like irreducibility, intestinal obstruction, abdominal distension with vomiting, or red shiny painful skin over the swelling. Surgery is always done under anesthesia. The defect in the muscles is defined and the edges of the muscles are brought together with sutures to close the defect. In general, the child needs to stay in the hospital for 1 day[10] and the healing is complete within 8 days.[citation needed]

At times, there may be a fleshy red swelling seen in the hollow of the umbilicus that persists after the cord has fallen off. It may bleed on touch, or may stain the clothes that come in contact with it. This needs to be shown to a pediatric surgeon. This is most likely to be an umbilical polyp and the therapy is to tie it at the base with a stitch so that it falls off and there is no bleeding. Alternatively, it may be an umbilical granuloma that responds well to local application of dry salt or silver nitrate but may take a few weeks to heal and dry.[11]

Treatment of adults[edit]

Many hernias never cause any problems, and does not require any treatment at all. A majority of umbilical hernias presumably belong in this cathegory.

Usually hernia has content of bowel, abdominal fat or omentum, tissue that normally would reside inside the abdominal cavity if it wasn't for the hernia. In some cases, the content get trapped in the hernia sac, outside the abdominal wall. The blood flow to this trapped tissue may be compromised, or the content even strangulated in some cases. Depending on the severity and duration of blood flow compromise, it can cause some pain and discomfort. Usually the situation resolves itself, when the protrusion of content is returned back to the abdominal cavity. Sometimes this needs to be done by a doctor at the ICU. [12]

If the hernia content get trapped combined with severe pain, inability to perform bowel movement or pass gas, swelling, fever, nausea and/or discoloration over the area, it could be signs of a prolonged compromise in blood flow of the hernia content. If so, emergency surgery is often required, since prolonged compromize in blood flow otherwise threatens organ integrity. [13]

Hernias that are symptomatic and disturb daily activity, or hernias that have had episodes of threatening incarceration, preventive surgical treatment can be considered. The surgery is performed under anaesthesia, while the surgeon identifies the edges of the defect and bring them together permanently using either suture or mesh[14]. Small umbilical hernias are often successfully repaired with suture, while larger hernias may require a suitable mesh[15], although some surgeons advocate mesh treatment for most hernias. The most common complications for both techniques are superficial wound infections, recurrence of the hernia[16] and some people experience pain from the surgical site [17].

See also[edit]

References[edit]

  1. ^ Lissauer, Tom; Clayden, Graham (2007). Illustrated Textbook of Paediatrics (3rd ed.). Edinburgh: Mosby Elsevier. ISBN 978-0-7234-3397-2. 
  2. ^ Abdominal Hernias at eMedicine
  3. ^ a b Meier, Donald E.; OlaOlorun, David A.; Omodele, Rachael A.; Nkor, Sunday K.; Tarpley, John L. (2001). "Incidence of Umbilical Hernia in African Children: Redefinition of 'Normal' and Reevaluation of Indications for Repair". World Journal of Surgery. 25 (5): 645–8. doi:10.1007/s002680020072. PMID 11369993. 
  4. ^ Arca, MD, Marjorie J. (November 2016). "APSA - Umbilical Conditions" (Website). APSA - Family and Parent Resources. Oakbrook Terrace, Illinois, USA: American Pediatric Surgical Association. Retrieved November 5, 2017. 
  5. ^ MedlinePlus Encyclopedia Umbilical hernia repair
  6. ^ Mayo Clinic staff. "Umbilical hernia: Causes - MayoClinic.com". Retrieved 2010-03-31. 
  7. ^ "Hernia: MedlinePlus Medical Encyclopedia". 2014-10-25. Retrieved 2016-07-15. 
  8. ^ a b c "UOTW #44 - Ultrasound of the Week". Ultrasound of the Week. 18 April 2015. Retrieved 27 May 2017. 
  9. ^ Papagrigoriadis, S.; Browse, D. J.; Howard, E. R. (1998). "Incarceration of umbilical hernias in children: a rare but important complication". Pediatric Surgery International. 14 (3): 231–2. doi:10.1007/s003830050497. PMID 9880759. 
  10. ^ Barreto, L.; Khan, A. R.; Khanbhai, M.; Brain, J. L. (2013-07-19). "Umbilical hernia". BMJ. 347: f4252. doi:10.1136/bmj.f4252. ISSN 1756-1833. PMID 23873946. 
  11. ^ "Child with Umbilical Swellings/Hernia". Archived from the original on April 7, 2013. Retrieved 2013-10-10. 
  12. ^ Summers, Anthony (2014-03-05). "Congenital and acquired umbilical hernias: examination and treatment". doi:10.7748/en2014.03.21.10.26.e1260. Retrieved 2018-02-20. 
  13. ^ Summers, Anthony (2014-03-05). "Congenital and acquired umbilical hernias: examination and treatment". doi:10.7748/en2014.03.21.10.26.e1260. Retrieved 2018-02-20. 
  14. ^ Nguyen, Mylan T.; Berger, Rachel L.; Hicks, Stephanie C.; Davila, Jessica A.; Li, Linda T.; Kao, Lillian S.; Liang, Mike K. (2014-05-01). "Comparison of Outcomes of Synthetic Mesh vs Suture Repair of Elective Primary Ventral Herniorrhaphy". JAMA Surgery. 149 (5). doi:10.1001/jamasurg.2013.5014. ISSN 2168-6254. 
  15. ^ Dalenbäck, J.; Andersson, C.; Ribokas, D.; Rimbäck, G. (2013-08-01). "Long-term follow-up after elective adult umbilical hernia repair: low recurrence rates also after non-mesh repairs". Hernia. 17 (4): 493–497. doi:10.1007/s10029-012-0988-0. ISSN 1265-4906. 
  16. ^ Winsnes, A.; Haapamäki, M. M.; Gunnarsson, U.; Strigård, K. (2016-08-01). "Surgical outcome of mesh and suture repair in primary umbilical hernia: postoperative complications and recurrence". Hernia. 20 (4): 509–516. doi:10.1007/s10029-016-1466-x. ISSN 1265-4906. 
  17. ^ Christoffersen, Mette W.; Helgstrand, Frederik; Rosenberg, Jacob; Kehlet, Henrik; Strandfelt, Pernille; Bisgaard, Thue. "Long-term recurrence and chronic pain after repair for small umbilical or epigastric hernias: a regional cohort study". The American Journal of Surgery. 209 (4): 725–732. doi:10.1016/j.amjsurg.2014.05.021. 

External links[edit]

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