An umbilical hernia occurs when abdominal tissue protrudes through the skin around the navel or belly button. A common congenital condition in newborns, it may also appear in adulthood, often precipitated or exacerbated by obesity, pregnancy, abdominal surgery or heavy lifting. Umbilical hernias, like other hernias, happen when part of an abdominal organ, usually the intestine, presses through a weak point in the abdominal wall.
Umbilical hernias are often inconsequential. In infants they are usually painless, becoming obvious only when the babies cry or strain during coughing or bowel movements. Congenital umbilical hernias usually resolve themselves by the time the infant is 2 years of age.
For adults, umbilical hernias may be painful, particularly during coughing or when straining during bowel movements or heavy lifting, and may require surgery. When the protruding tissue of a hernia becomes obstructed to the point that tissue is not nourished, serious medical problems may result and surgery becomes urgent.
Risk Factors for an Umbilical Hernia
When umbilical hernias occur in adults, they do so for a number of reasons. The causes of umbilical hernias may include:
- Being overweight
- Being pregnant
- An accumulation of fluid in the belly, known as ascites
- Chronic coughing
- Chronic constipation
- Enlarged prostate or problems urinating
If an umbilical hernia enlarges or becomes painful, it may require surgical intervention.
Diagnosis of an Umbilical Hernia
An umbilical hernia is usually easy to diagnose with physical examination since the protruding tissue can be palpated. It is often possible for the protrusion to be pushed manually back into the abdomen, but as long as that section of the abdominal wall remains weak, the hernia will recur. In an obese individual, the umbilical hernia may be more difficult to find. In such a case, or when a complication is suspected, a diagnostic test, such as an X-ray or an ultrasound, may be administered.
Complications of an Umbilical Hernia
When an umbilical hernia becomes incarcerated or trapped outside the body, it is at risk of strangulation. Once a hernia strangulates, the blood supply to the affected tissue is cut off and emergency surgery is required. This situation is serious since the affected tissue may become necrotic, or die, and systemic infection may develop. Symptoms of a strangulated hernia may include:
- Serious pain, swelling and discoloration at the site
- Inability to move the bowels
- Inability to pass gas
- Nausea and vomiting
The Umbilical Hernia Repair Procedure
While a strangulated umbilical hernia may be life-threatening, surgery to repair an umbilical hernia has few risks. As with all surgeries, the procedure is safest when performed prophylactically before the situation becomes dangerous.
The surgical repair of an umbilical hernia is normally performed outpatient under general anesthesia. The surgeon makes a small incision just above or below the navel, pushes the protruding tissue back inside the abdomen and sutures it in place. A piece of mesh is usually stitched over or under the weakened area so that the hernia will not recur.
Risks of an Umbilical Repair Procedure
Hernia repairs are among the most common and safest surgical procedures performed in the United States. Complications are very rare. Nonetheless, as with any surgery, there are risks patients should be take into account. The risks of any surgical procedure may include:
- Excessive bleeding
- Blood clots
- Adverse reactions to anesthesia or medications
- Post-surgical infection
- Damage to adjacent organs
- Breathing problems
- Re-herniation at the incision site