Resumo
Definition
A hérnia umbilical é um defeito da fáscia da parede abdominal anterior que ocorre quando o anel umbilical não se fecha. O defeito propicia a protrusão de um saco peritoneal que é coberto por pele e pode apresentar conteúdo intra-abdominal, como omento ou intestino.[Figure caption and citation for the preceding image starts]: Grande hérnia umbilicalAcervo pessoal de Charles L. Snyder, MD; usado com permissão [Citation ends].
History and exam
Key diagnostic factors
- presença de fatores de risco
- presença desde o nascimento
- protuberância no umbigo
- alteração no tamanho/tensão durante o movimento
- alterações cutâneas
- saco herniário facilmente redutível
- borda da fáscia bem-definida com defeito central
- diâmetro variável do defeito
- sintomas de obstrução do intestino delgado
Other diagnostic factors
- desconforto intermitente
Risk factors
- baixo peso ao nascer
- Ancestralidade africana
- síndrome de Beckwith-Wiedemann (BWS)
- trissomia dos cromossomos 21, 18, 13
- hipotireoidismo congênito
- mucopolissacaridose
Diagnostic investigations
1st investigations to order
- o diagnóstico é clínico
Treatment algorithm
hérnia encarcerada
hérnia grande ou sintomática
hérnia pequena e assintomática
Contributors
Authors
Charles L. Snyder, MD
Professor of Surgery
Chief, Section of Surgery
University of Missouri-Kansas City
Children's Mercy Hospital
Kansas City
MO
USA
Disclosures
CLS declares that he has no competing interests.
Acknowledgements
Dr Charles L. Snyder wishes to gratefully acknowledge Dr Charles M. Leys, a previous contributor to this topic.
Disclosures
CML declares that he has no competing interests.
Peer reviewers
Michael A. Skinner, MD
Professor and Vice Chairman
Pediatric Surgery
University of Texas Southwestern Medical Center
Dallas
TX
USA
Disclosures
MAS declares that he has no competing interests.
Bangalore S. Ramanand, MS, DNB, FRCS, MSC
Locum Consultant Surgeon
Glan Clwyd Hospital
Rhyl
UK
Disclosures
BSR declares that he has no competing interests.
LS Wong, MB ChB
Consultant Surgeon
Honorary Associate
Professor of Surgery
University Hospitals Coventry
UK
Disclosures
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
USA
Disclosures
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.
References
Key articles
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. Abstract
Bowling K, Hart N, Cox P, et al. Management of paediatric hernia. BMJ. 2017 Oct 19;359:j4484. Abstract
Halpern LJ. Spontaneous healing of umbilical hernias. JAMA. 1962 Nov 24;182(8):851-2. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Diagnósticos diferenciais
- Hérnia epigástrica
- Hérnia do cordão umbilical
- Onfalocele
More Differentials
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