Central umbilical hernia
- Occurs following failed fusion of the anterior abdominal wall after birth.
- Often evident a few days after delivery.
- The hernias are usually small.
- The underlying defect is usually smaller than the visible hernia.
- A cough reflex is present.
- Most settle spontaneously and parents can be reassured.
- Surgeons are usually unhappy to operate before one year old.
- Strangulation never occurs in central hernias.
- Occur as a central swelling usually above or below the umbilicus.
- These hernias may become very large.
- More common in adults (especially women), than children.
- May be associated with obesity and weak abdominal muscles.
- The sac may contain both bowel and omentum.
- This is a true defect in the linea alba close to the umbilicus.
- These hernias will not resolve without surgical intervention.
- The patient should be advised to lose weight.
- Surgical repair is recommended because of strangulation risk.
Contributed by Dr Nigel Stollery, a GP in Kibworth, Leicestershire and a clinical assistant in dermatology at Leicester Royal Infirmary