Umbilical hernia symptoms and treatment | Umbilical hernia surgery | Dr Shipra | hernia |

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An umbilical hernia is an abnormal bulge that can be seen or felt at the umbilicus (belly button). 
Umbilical hernia of newborn
Umbilical hernia of infants and children
Umbilical hernia of adults.

Umbilical hernia of newborn- (1 in 6000 live births)
It is called Omphalocoele- Exomphalos.
During gestation, the umbilical cord passes through a small opening in the baby's abdominal muscles. The opening normally closes just after birth. If the muscles don't join together completely in the midline of the abdominal wall, an umbilical hernia may appear at birth or later in life.

It is also associated with weakness of abdominal musculature.Umbilical hernia develops due to either absence of umbilical fascia or incomplete closure of umbilical defect.
TWO types-
1. Exomphalos minor
In this condition, the umbilical cord is attached to the summit of the sac.

Sac is small and defect less than 4 cm.

It is treated by twisting the cord and ligating the sac. Care should be taken to avoid damage to the intestine. For example, nursing the child preoperatively in prone position can damage intestines.
2. Exomphalos major
In this condition, the umbilical cord is attached to the inferior aspect of the sac, containing intestines, abdominal structures e.g. liver, bowel. This is usually associated with absent abdominal musculature.

Surgery done- before the rupture of the sac as the morbidity increases greatly in the event of a rupture of the sac.

During the operation, skin flaps are raised on both sides to cover the defect. A true Staged repair is necessary and is done at a later date
UMBILICAL HERNIA OF INFANTS AND CHILDREN
It occurs as a complication of umbilical sepsis, which weakens the umbilical scar.

Clinical features-

Common- Male children

The child is brought with the complaint of swelling in the umbilical region whenever the child cries.

Most of the cases are symptomless. Parents are anxious about the swelling.

Strangulation is rare

It is a true umbilical hernia containing either omentum/ intestines.

Treatment-

Reassurance is the most important advice given to the parents.

No treatment is required other than strapping the abdominal wall by keeping a pad in front of umbilicus.

Majority of the hernias get corrected by 2 years of age (90%).

If the hernia does not correct itself, repair is necessary to close the defect in the linea alba.

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