umbilical hernia

What is an Umbilical Hernia?

An umbilical hernia is a medical condition characterized by a soft swelling or bulge near the navel (belly button). This occurs when part of the intestine protrudes through the umbilical ring, a small opening in the abdominal wall that was present during fetal development.

Symptoms and Characteristics

• A painless lump appears in or near the belly button
• The bulge may get bigger when laughing, coughing, crying, or going to the toilet
• It can occur at any age, but is more common in children and adults
• In adults, it can be a sign of a more serious underlying condition

Causes and Types

• An umbilical hernia occurs when part of the bowel or fatty tissue pushes through a weak spot in the abdominal wall near the navel
• It can be congenital (present at birth) or acquired later in life due to various factors such as obesity, pregnancy, or straining during bowel movements

References

• [1] An umbilical hernia creates a soft swelling or bulge near the navel.
• [2] An umbilical hernia occurs at the umbilicus (belly button) when a loop of intestine pushes through the umbilical ring, a small opening in a fetus' abdominal wall.
• [3] An umbilical hernia is a tissue bulge on or near your belly button.
• [6] An umbilical hernia occurs when part of the bowel or fatty tissue pushes through a weak spot in the abdominal wall, near the navel.
• [7] An umbilical hernia occurs when part of the intestine or fatty tissue bulges through the muscle near the belly button (navel, umbilicus).

Common Signs and Symptoms of Umbilical Hernia

An umbilical hernia can manifest in various ways, depending on the individual case. Here are some common signs and symptoms to look out for:

• Visible Bulge: A soft, painless lump or bulge near the belly button (navel) is a classic sign of an umbilical hernia.
• Bulge that gets bigger: The bulge may become more noticeable when coughing, sneezing, laughing, crying, or straining to have a bowel movement.
• Pain: While not always present, pain can range from a dull ache to severe pain, especially when the abdominal wall constricts around the hernia.
• Nausea and Vomiting: In some cases, nausea and vomiting may occur due to the constriction of the abdominal wall around the hernia.
• Fever: A fever can be a sign of a strangulated umbilical hernia, where the intestine becomes trapped in the hernia sac.

Other Possible Symptoms

In addition to these common signs and symptoms, some people may experience:

• Abdominal pain and tenderness
• Constipation
• Fullness or roundness of the abdomen
• Redness or discoloration of the bulge

It's essential to note that not everyone with an umbilical hernia will exhibit all of these symptoms. If you suspect you or your child has an umbilical hernia, consult a healthcare professional for proper evaluation and treatment.

References

1. [4] A bulge or swelling in or near the belly button; A bulge that gets bigger when coughing, straining to have a bowel movement, or sitting up; Nausea or vomiting
2. [6] The main sign of an umbilical hernia is a visible bump under the skin by the belly button.
3. [7] Signs and symptoms include: A bulge in the affected area; Pain — which can range from a dull ache to severe pain — especially when coughing, sneezing or lifting
4. [8] An umbilical hernia appears as a painless lump in or near the belly button (navel). It may get bigger when laughing, coughing, crying or going to the toilet
5. [12] Symptoms of a strangulated umbilical hernia include: fever; constipation; severe abdominal pain and tenderness; nausea and vomiting; a bulging lump in the abdomen; redness or other discoloration

Diagnostic Tests for Umbilical Hernia

Umbilical hernias can be diagnosed through various tests, which help confirm the presence and severity of the condition.

• Physical Exam: The most common way to diagnose an umbilical hernia is through a physical exam by a healthcare provider. They will inspect the area around the navel for any visible bulges or swelling.
• Imaging Studies: Imaging studies such as abdominal ultrasound, CT scan, and MRI may be used to confirm the diagnosis and rule out other conditions. These tests can help identify the size and location of the hernia, as well as any potential complications (1).
• Blood Tests: Blood tests may be ordered to check for signs of infection or strangulation of the intestine, which can occur if the hernia becomes trapped (3).

Additional Diagnostic Procedures

In some cases, additional diagnostic procedures may be necessary to confirm the diagnosis and rule out other conditions. These may include:

• Barium X-ray: A barium X-ray may be ordered to help identify any blockages or narrowing of the intestine.
• Ultrasound: An ultrasound may be used to examine the abdominal muscles and surrounding tissues for any signs of damage or weakness (6).
• MRI Scan: An MRI scan can detect a tear in the abdominal muscles, which can contribute to the development of an umbilical hernia (6).

References

1. A visible bulge on or near your belly button that's soft to the touch is the most common sign of an umbilical hernia (2).
2. The provider may order blood tests to look for signs of infection resulting from the strangulated intestine (3).
3. An MRI scan can detect a tear in the abdominal muscles, which can contribute to the development of an umbilical hernia (6).

There is no specific drug treatment for umbilical hernia.

However, there are some medications that may be used to manage symptoms or complications related to umbilical hernia.

• Pain management: Pain relief medication such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may be prescribed to alleviate discomfort or pain associated with the condition.
• Antibiotics: If an umbilical hernia becomes infected, antibiotics may be prescribed to treat the infection.

It's worth noting that surgery is usually the only effective treatment for umbilical hernia.

According to [6], many umbilical hernias close on their own by ages 3 to 4, and surgical repair is advised if closure does not occur by this time.

In some cases, a doctor may recommend surgery if an infant's umbilical hernia persists beyond the age of 2 years [8].

Medications are not a substitute for proper medical evaluation and treatment.

If you suspect that you or your child has an umbilical hernia, it is essential to consult with a qualified healthcare professional for proper diagnosis and treatment.

References:

[6] Many umbilical hernias close son their own by ages 3 to 4. [8] Treatment. In infants, most umbilical hernias will resolve within 2 years...

Differential Diagnosis of Umbilical Hernia

Umbilical hernias can be challenging to diagnose, as they may present with similar symptoms to other abdominal wall defects. A thorough understanding of the differential diagnosis is essential for accurate identification and treatment.

Key Conditions to Consider:

• Epigastric Hernia: This type of hernia occurs through a defect in the abdominal wall above the navel (umbilicus). It can be difficult to distinguish from an umbilical hernia, especially if it is located near the umbilicus.
• Spigelian Hernia: Also known as lateral ventral hernias, these occur along the edge of the rectus abdominis muscle. They can present with similar symptoms to umbilical hernias and may require surgical repair.
• Incisional Hernia: This type of hernia occurs through a previous surgical incision in the abdominal wall. It can be difficult to distinguish from an umbilical hernia, especially if it is located near the site of the original surgery.

Other Conditions to Consider:

• Benign Lesions: Such as epidermoid cysts, omphalitis (inflammation of the navel), and foreign body granuloma can present with similar symptoms to umbilical hernias.
• Endometriosis: This condition occurs when tissue from the lining of the uterus grows outside the pelvic area. It can cause pain and discomfort in the abdominal region, which may be mistaken for an umbilical hernia.

References:

• [1] DC Brooks (2019) - Differential diagnosis of primary ventral hernias
• [3] Dec 9, 2023 - Differential diagnosis of umbilical hernia
• [7] by R Lombardi · 2010 · Cited by 1 - Differential diagnosis comprises umbilical hernia, benign lesions (ie, epidermoid cysts, omphalitis, foreign body granuloma), endometriosis, and skin ...

Citations:

[3][7]