Resumo
Definição
Umbilical hernia is a defect of the anterior abdominal wall fascia that occurs when the umbilical ring fails to close. The defect allows protrusion of a peritoneal sac that is covered by skin and may contain intra-abdominal contents, such as omentum or bowel.[Figure caption and citation for the preceding image starts]: Large umbilical herniaPersonal collection of Charles L. Snyder, MD; used with permission [Citation ends].
História e exame físico
Principais fatores diagnósticos
- present since birth
- bulge at the umbilicus
- change in size/tension during movement
- skin changes
- easily reducible hernia sac
- well-defined rim of fascia with central defect
- variable diameter of defect
- symptoms of small bowel obstruction
Outros fatores diagnósticos
- intermittent discomfort
Fatores de risco
- low birth weight
- African ancestry
- Beckwith-Wiedemann syndrome (BWS)
- trisomy 21, 18, 13
- congenital hypothyroidism
- mucopolysaccharidoses
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- diagnosis is clinical
Algoritmo de tratamento
incarcerated hernia
large or symptomatic hernia
small and asymptomatic hernia
Colaboradores
Autores
Charles L. Snyder, MD
Professor of Surgery
Chief, Section of Surgery
University of Missouri-Kansas City
Children's Mercy Hospital
Kansas City
MO
Declarações
CLS declares that he has no competing interests.
Agradecimentos
Dr Charles L. Snyder wishes to gratefully acknowledge Dr Charles M. Leys, a previous contributor to this topic.
Declarações
CML declares that he has no competing interests.
Revisores
Michael A. Skinner, MD
Professor and Vice Chairman
Pediatric Surgery
University of Texas Southwestern Medical Center
Dallas
TX
Declarações
MAS declares that he has no competing interests.
Bangalore S. Ramanand, MS, DNB, FRCS, MSC
Locum Consultant Surgeon
Glan Clwyd Hospital
Rhyl
UK
Declarações
BSR declares that he has no competing interests.
LS Wong, MB ChB
Consultant Surgeon
Honorary Associate
Professor of Surgery
University Hospitals Coventry
UK
Declarações
LSW declares that he has no competing interests.
Emmanuel Atta Agaba, MD, FRCS, FACS
Fellow in Minimally Invasive Surgery
Montefiore Medical Center at Albert Einstein College of Medicine
Bronx, New York City
NY
Declarações
EAA declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Vohr BR, Rosenfield AG, Oh W. Umbilical hernia in the low-birth-weight infant (less than 1,500 gm). J Pediatr. 1977 May;90(5):807-8. Resumo
Bowling K, Hart N, Cox P, et al. Management of paediatric hernia. BMJ. 2017 Oct 19;359:j4484. Resumo
Halpern LJ. Spontaneous healing of umbilical hernias. JAMA. 1962 Nov 24;182(8):851-2. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Epigastric hernia
- Hernia of the umbilical cord
- Omphalocele
Mais Diagnósticos diferenciais
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