What are Umbilical and Paraumbilical Hernias?
These are lumps near the umbilicus( belly-button). Umbilical hernias occur in children mostly while adults develop paraumbilical hernias (next to the umbilicus).
What are the causes of these hernias?
They occur when there is a defect in the abdominal wall near the umbilicus allowing intestine or fat from inside of the abdomen to protrude through the defect. These hernias are quite common as the umbilicus is a weak spot in the abdominal wall.
Umbilical hernias occur in children and tend to be congenital.
Paraumbilical hernias occur in adults and are acquired. They are caused by:
- Straining and heavy lifting
- Chronic coughing or constipation
- Previous abdominal or groin surgery
- Congenital weakness of the connective tissue
- Liver diseases
What are the symptoms?
Some hernias do not cause any symptoms and are picked up by the doctor. Usual symptoms are discomfort and a bulge that gets bigger when standing or coughing and disappears when lying flat.
What are the complications of umbilical hernias?
- Strangulation: the fat or the bowel inside the hernia can get strangulated by the tight margin of the hernia leading to gangrene within few hours.. This is a surgical emergency and if not fixed promptly, can lead to bowel perforation.
- Bowel obstruction: occasionally the bowel inside the hernia get obstructed. This tend to quickly progress to strangulation and gangrene.
- Stretched out umbilicus skin and skin ulceration and infection.
- Rupture of the umbilicus skin if neglected.
Can these hernias be left without treatment?
Umbilical hernias in young children can be observed as some disappear by themselves. However hernias in older children and adults will never heal but instead tend to increase in size with time.
The bigger the hernia the more likely patients will develop complications including strangulation of a loop of intestine trapped inside the hernia . This is a life threatening complication that requires urgent operation often involving resection of the trapped bowel.
Watchful waiting is an option if you have a small hernia with no symptoms.