What is an umbilical hernia?
An opening or ‘hole’ in the abdominal wall at the umbilicus (navel, or belly button) allows abdominal contents to protrude through, just under the skin. When pressure inside the abdomen increases, eg with crying or straining, the hernia enlarges.
How common is it?
Approximately one in 10 infants develop an umbilical hernia soon after birth. Nine out of 10 of these will resolve by themselves.
What problems can an umbilical hernia cause?
It is very rare for umbilical hernias in infants or young children to cause pain or complications. It is safe to wait a few years for the hernia to resolve spontaneously. Even large hernias that bulge impressively with staining or crying can be safely observed.
In school aged children the protruding belly button can be a cause for teasing by other children.
In adults and especially in pregnant women, bowel or tissue can become stuck in an umbilical hernia necessitating urgent surgery.
What treatment is recommended?
Before age 3 years, no treatment is necessary. In the past some people have tried to use straps, buttresses or even a penny to keep the hernia pushed in. Please note, these are not recommended because they can damage the skin over the hernia and do nothing to hasten resolution.
After age 3 years, operative repair is recommended.
What to expect after the operation
Stitches
The stitches are dissolvable and generally cannot be seen because they run under the skin.
Pain
Your surgeon or anaesthetist will usually use local anaesthetic to reduce pain after the operation. This wears off after a few hours. At home, give paracetamol for pain relief (see post-operative instructions).
Dressing
The dressing is waterproof so normal bathing or showering is allowed after the operation.
A small amount of blood may appear underneath the dressing. This is common, but if bleeding seeps out from under the dressing or is excessive, call you surgeon.
Appearance of the umbilicus
There will be a curved scar under the umbilicus.
Because the hernia has stretched the skin, it is common for come excess skin to remain after the operation. This skin may protrude a little giving the appearance of a persistent bulge. This generally settles down over the years as the child grows.
What are some of the risks of the operation?
- Bleeding
- Infection in the wound
- Recurrence of the hernia
All these possible complications are very uncommon. Children with rare disorders that cause weak tissues are more prone to recurrence of the hernia.
