Umbilical hernia describes the protrusion of fatty tissue or part of the intestine in a sac through the abdomen into the navel, appearing like a bulge through the navel. Most patients with umbilical hernia are usually born with it. It occurs in about 15% of children at birth; more common in children born prematurely. It affects male and female equally.
Umbilical hernia occurs due to an opening left around the navel while the abdominal muscles are developing as the baby is being formed during pregnancy. Bowels and / or fatty tissue may then protrude into this defect to produce the swelling in the umbilicus.
This protrusion may be there all the time or may only become noticeable when there is pressure within the abdominal cavity caused by crying, coughing, laughing or straining while defecating.
Umbilical hernia hardly causes pain in children because of its large neck which allows free movements of its contents in and out. As the child grows and the tissues around the hernia also grow, the neck may get narrowed, and this may encourage tissues that protrude into the space, such as the intestine, to get trapped inside it.
This may obstruct blood flow into that segment of the trapped tissues, leading to their strangulation. This manifests as pain which may be severe.
In children, umbilical hernia may close spontaneously between three and five years of age. After this age, it may require surgery to fix. This aim of the surgery is to close the space where the abdominal structure is protruding from.
This helps prevent the bowel or fatty tissue protruding from it from getting trapped and strangulated later in life. Parents are advised to wait until the child is more than five years before going for surgery in order to allow for time for those that will close on their own before then.
Umbilical hernia cannot be prevented because it is due to natural developmental defect in the structure around the navel. Its complications can be prevented by repairing it at the appropriate time before tissues get trapped in it and get strangulated.
