Umbilical hernias will usually close by 4 to 5 years of age without treatment.
Complications including incarceration, strangulation, and rupture are uncommon in children.
Elective outpatient repair is associated with a low recurrence rate.
Infection and bleeding are the two most common postoperative complications.
Compression therapy (such as abdominal binders) is not helpful and may be harmful.
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.
History and exam
Key diagnostic factors
- 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
Other diagnostic factors
- intermittent discomfort
- low birth weight
- African ancestry
- Beckwith-Wiedemann syndrome (BWS)
- trisomy 21, 18, 13
- congenital hypothyroidism
1st investigations to order
- diagnosis is clinical
large or symptomatic hernia
small and asymptomatic hernia
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