Umbilical hernia
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| ICD-10 | K42 |
|---|---|
| ICD-9 | 551-553 |
Umbilical hernia is a congenital malformation, especially common in infants of African descent, and more frequent in boys. A hernia is present at the site of the umbilicus (commonly called a navel, or belly button) in the newborn; although sometimes quite large, these hernias tend to resolve without any treatment by around the age of 5 years. Obstruction and strangulation of the hernia is rare because the underlying defect in the abdominal wall is larger than in an inguinal hernia of the newborn.
Babies are prone to this malformation because of the process during fetal development by which the abdominal organs form outside the abdominal cavity, later returning into it through an opening which will become the umbilicus.
Importantly this type of hernia must be distinguished from a para-umbilical hernia which occurs in adults and involves a defect in the midline near to but not through the umbilicus, and from omphalocele.
When the orifice is small (< 1 or 2cm), 90% closes within 3 years, and if these hernias are asymptomatic, reducible, and don't enlarge, no surgery is needed (and in other cases it must be considered). However, in some communities mothers routinely push the small bulge back in and tape a coin over the palpable hernia hole until closure occurs. This practice is not medically recommended as there is a small risk of trapping a loop of bowel under part of the coin resulting in a small area of ischemic bowel. The use of bandages or other articles to continuously reduce the hernia is not evidence-based.
Umbilical hernias in adults are largely acquired, and more frequent in pregnant women. Abnormal decussation of fibers at the linea alba may contribute.
