Umbilical Hernia - Causes, Symptoms, Treatment
Umbilical hernias often occur in adulthood because of progressive and significant tension on the congenital area of weakness beneath the navel. This develops through the normal stresses and strains of daily activity. Standard techniques still widely utilized today attempt to repair these hernias by simply closing the muscle defect with sutures placing the muscle tissue under significant tension. In children, there is a hole between the muscle layers of the abdomen where the arteries and veins that passed down the umbilical cord from the mother entered the baby. This hole normally closes quickly after birth, but in some children the hole is very large, or is slow to close. In these cases, bulging of the intestine into the area just below the skin of the umbilicus can occur. This is more common in premature babies, as the processes involved in closing the hole behind the umbilicus are slower.
Causes
An umbilical hernia in an infant occurs when the muscle through which blood vessels pass to feed the developing fetus doesn’t close completely. Umbilical hernias are common in infants. They occur slightly more often in African Americans. Most umbilical hernias are not related to disease. However, umbilical hernias can be associated with rare conditions such as mucopolysaccharide storage diseases, Beckwith-Wiedemann syndrome, and Down syndrome.
During pregnancy, the umbilical cord passes through a small opening in the baby’s abdominal muscles. The opening normally closes before birth. If the muscles don’t meet together in the midline completely, this weakness in the abdominal wall may cause an umbilical hernia at birth or later in life.
Symptoms
Umbilical hernias appear as a bulge or swelling in the belly button area. The swelling may become more noticeable when the baby cries, and may become smaller or disappear when the baby is quiet. If a physician gently pushes on the bulge when a child is lying down and calm, it will usually get smaller or go back into the abdomen. Sometimes the intestines get trapped within the umbilical hernia.
The main symptom of an umbilical hernia is a soft bulge under the skin of the navel. You may be able to push part of the hernia so that it temporarily moves back into the abdomen. The hernia may be more noticeable when your child sits or stands upright or strains abdominal muscles during normal activities such as crying, coughing, or having a bowel movement.
Diagnosis
Your doctor will examine your belly button. The belly button will usually bulge out if you have an umbilical hernia. An umbilical hernia can cause serious illness if it’s left untreated in adults. The risk of illness increases with the size of the hernia. Your GP or surgeon will usually recommend umbilical hernia repair.
Treatment
Usually, no treatment is required unless the defect persists beyond the age of 2 years. In rare cases, intestines become strangulated ie. the blood supply becomes constricted and this results in a tense, shiny swelling at the naval that will not reduce in size. The child is irritable and starts vomiting. This is an emergency situation and surgery must be performed immediately.
An umbilical hernia can be fixed 2 different ways. The surgeon can opt to stitch the walls of the abdominal or he/she can place mesh over the opening and stitch it to the abdominal walls. The latter is of a stronger hold and is commonly used for larger tears in the abdominal wall. Most surgeons will repair the hernia 6 weeks after the baby is born.
