A hernia occurs when tissue or part of an organ, usually the intestine, protrudes through a weak point or tear in the abdominal wall. The protruding tissue may lose blood supply and become obstructed, which can result in serious problems. An umbilical hernia is a protrusion of the abdomen around the belly button. This is often a congenital disorder common in infants, but it may also appear during adulthood. In adults, it may be exacerbated by factors such as obesity, pregnancies, abdominal surgery or heavy lifting.
Symptoms of an Umbilical Hernia
An umbilical hernia presents as a bulge in the abdomen near the navel. In an infant, the umbilical hernia may only be visible during periods of crying, coughing or straining during urination or bowel movements. They typically do not cause discomfort and often resolve on their own by the time the child is 2 years old.
Conversely, in adults an umbilical hernia may be tender or painful, especially when lifting heavy objects, coughing or straining. The hernia may seem to disappear at times when the protruding tissue is pushed back inside the abdominal wall, but once the weakness exists, the hernia will inevitably reappear.
If it becomes very painful, there is discoloration or swelling in the area or nausea and vomiting begin, medical attention should be sought immediately. This may be an indication of the development of a complication, which typically results from the affected tissue becoming confined outside of the abdomen. When this occurs, the blood supply to the tissue may be limited or restricted completely, which can be damaging to the abdominal tissue and cause an infection.
Diagnosis of an Umbilical Hernia
A doctor can usually confirm the presence of an umbilical hernia during a physical exam. The mass may increase in size when the patient coughs, bends, lifts or strains the abdominal muscles. The doctor will likely ask a number of questions about the nature of the symptoms and when they are experienced. The telltale bulge of a hernia may not be obvious in infants or children except when they are crying or coughing. Umbilical hernias may also be difficult to locate upon the physical examination of an obese person. In such cases, diagnostic imaging such as an X-ray or ultrasound may be employed to verify the existence of a hernia or complications that may be arising.
Repair of an Umbilical Hernia
While umbilical hernias can occasionally be pushed back into place temporarily by a physician, surgery is the only method to permanently correct them. Hernia surgery is one of the most common surgical procedures performed in the United States. Physicians usually recommend surgery when hernias are large, painful or interfering with everyday activities. Such surgical procedures are often undertaken prophylactically to prevent the development of a dangerous, incarcerated hernia in the future.
During a procedure to repair an umbilical hernia, the surgeon usually covers the affected area with surgical mesh after the incision is made to prevent further weakness or tearing of the abdominal wall. Although repairs may be made using the patient's own tissue without surgical mesh, such repairs have a lower rate of success over time. The procedure involves the creation of an incision just below the navel. The surgeon will reposition the affected tissue within the abdomen and suture the opening in the abdominal wall, applying the mesh where necessary. Once it has been surgically repaired, an umbilical hernia rarely returns.
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