Umbilical Hernia: Symptoms, Diagnosis & Management
What Is an Umbilical Hernia?
A defect in the abdominal wall at the umbilicus allowing peritoneum ± abdominal contents (omentum, bowel) to protrude.
Common Symptoms
- Visible/ palpable bulge at navel – more prominent standing, coughing, straining; may reduce supine.
- Discomfort or pain at site – aching, burning, sharp with strain.
- Skin changes: Erythema, thinning, discoloration if incarcerated/strangulated.
- Obstruction signs (urgent): Nausea, vomiting, abdominal distension, constipation/obstipation, severe pain – suggests incarcerated/strangulated bowel.
- Infants: Often asymptomatic; bulge cries when straining. Most close spontaneously by age 1–2.
Diagnosis
- Clinical exam (reducible? tender? bowel sounds?).
- Ultrasound/CT if diagnosis uncertain or planning repair.
Management
- Infants: Observation; repair if >2 cm, symptomatic, or not closed by age 3–4.
- Adults: Elective surgical repair (open or laparoscopic, usually with mesh) recommended for symptomatic hernias or those at risk for incarceration. Asymptomatic small hernias can be watched.
- Emergency surgery for incarceration/strangulation.
When to Seek Care
New bulbe, pain, vomiting, inability to reduce, skin changes → urgent evaluation.
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