The umbilical ring is the weakest point on the anterior abdominal wall. Therefore, it is one of those places where hernial protrusions most often form. Loops of intestine, omentum and other organs can exit through the umbilical ring in adults.
Facts about umbilical hernias:
- constitute 5% of all abdominal hernias in adults;
- most often found in women over 40 years of age;
- the disease was first described by the ancient Roman physician Celsus, who lived in the 1st century AD;
- The first successful operation for an umbilical hernia was performed in France in 1885.
Features of the anatomy of the anterior abdominal wall and navel area
The side and front walls of the abdomen, which protect the internal organs, consist mainly of the abdominal muscles. They are arranged in three layers, their bundles pass in different directions and provide different types movements.The only place where the abdomen is not protected by muscles is the narrow white line, which runs in the front center from the sternum to the pubis.
White line – this is the junction of the abdominal muscles located on the right and left. It is formed by their aponeuroses - bundles connective tissue. In the upper part, the white line of the abdomen is narrower and thicker, in the lower part it is wider and thinner, and therefore weaker.
While the fetus is in the womb of a pregnant woman, it has a rounded hole in the linea alba of the abdomen - the umbilical ring. The umbilical cord passes through it, connecting the mother and child. 
The umbilical cord includes:
- umbilical arteries;
- umbilical veins;
- urinary duct.
The organs that prolapse into the hernial protrusion are located in the hernial sac. It is represented by the peritoneum - a thin film of connective tissue that lines the inside abdominal cavity and covers the internal organs.
Causes of umbilical hernia in adults:
- Congenital expansion of the umbilical ring, when it is not completely scarred and a small hole remains. This may not manifest itself in any way in childhood, but over time, under certain conditions, an umbilical hernia forms.
- Pregnancy and childbirth. During pregnancy, a woman's belly increases and the navel stretches because of this. Constipation occurs, which leads to increased pressure inside the abdomen. The risk is especially high in women who have given birth more than once and who did not follow doctor's recommendations during pregnancy. Also, the occurrence of an umbilical hernia can be caused by difficult childbirth, a large fetus, polyhydramnios, and pregnancy with twins and triplets.
- Sedentary lifestyle. If a person neglects physical activity, his abdominal muscles weaken.
- Excessive exercise. When lifting heavy weights, the pressure inside the abdomen increases greatly.
- Diseases accompanied constant increase intra-abdominal pressure. It could be diseases digestive system, during which there is constant constipation, chronic cough, etc.
- Obesity. Subcutaneous fat is additional weight. It leads to stretching of the anterior abdominal wall.
- Postponed surgeries. Hernias in the navel area can also occur locally postoperative sutures. The risk increases greatly if the patient does not comply with the doctor’s recommendations, begins to manifest symptoms too early physical activity.
- Abdominal injury.
- Losing weight too quickly. This can happen when a person is on a strict diet or is seriously ill, resulting in exhaustion. The umbilical ring is weakened, creating conditions for the formation of a hernial protrusion.
Signs of an umbilical hernia in adults
Protrusion in the navel area. The most characteristic and clearly visible symptom of an umbilical hernia. It can be of various sizes. Sometimes the protrusion is barely noticeable; in a lying position it is not visible at all. And sometimes it’s very big. If you put your fingers on the protrusion and cough slightly and strain, you can feel a characteristic jolt.
If you press on the protrusion, it usually disappears - the hernia is reduced inside the abdomen. A large hernia, complicated by adhesions in the navel area, can become irreducible - it never disappears. Usually this causes pain, indigestion, nausea, vomiting, and constipation. If part of the hernial protrusion gets into Bladder– problems arise with urination.
Pain in patients with an umbilical hernia usually occurs only with intense physical activity, during coughing, sneezing, constipation. 
Symptoms of an umbilical hernia in a pregnant woman:
- the navel protrudes strongly;
- when feeling the navel, it feels like an empty cavity;
- There are clicks in the stomach: the sound resembles the bursting of bubbles.
Complications of umbilical hernia
- Infringement. If part of the intestine or other organ is pinched in the umbilical ring, then sharp pains(they can be of varying strength) associated with compression of nerves and blood vessels. Constipation, nausea, and vomiting occur. After 2-8 hours, the strangulated part of the organ begins to die due to the fact that blood does not flow to it. Symptoms intensify, the patient's condition becomes more severe. After 8 hours, the wall of the organ usually dies, and peritonitis develops - inflammation of the abdominal cavity. The patient's life is in danger.
- Intestinal obstruction- a condition in which the part of the intestine located in the hernia becomes clogged with feces. This complication is very similar to strangulation and manifests itself similar symptoms.
- Inflammation of an organ located in the hernial sac. Pain, swelling, redness in the area of the hernial protrusion occurs, body temperature rises, and general state patient.
Diagnosis of umbilical hernia in adults
Which doctor should I contact for an umbilical hernia?
If you have symptoms similar to those of an umbilical hernia, you need to contact a surgeon. An umbilical hernia is dangerous not only because of its complications. If a protrusion and thickening occurs in the navel area, this may be a metastasis. malignant tumor stomach. This rarely happens, but in every case it must be excluded. The doctor will examine you and prescribe an examination. How does the surgeon's examination proceed?
- The doctor asks the patient to undress to the waist.
- He examines the abdomen in a standing or lying position.
- The surgeon feels the protrusion, asks the patient to cough a little and strain to feel the push characteristic of an umbilical hernia.
- The doctor can also examine the groin area, thigh, and scrotum in men in order to rule out an inguinal and femoral hernia.
What questions might the doctor ask?
- When did the protrusion in the navel appear?
- Are you bothered by pain?
- Are you worried about digestive disorders: bloating, constipation, heaviness, belching, heartburn, nausea, vomiting?
- Have you had any previous surgical interventions?
- Did the patient's immediate family suffer from an umbilical hernia?
Examination for umbilical hernia
| Study title | Description | How is it carried out? |
| Ultrasound for umbilical hernia | Information that ultrasound can provide for an umbilical hernia:
| Ultrasound examination for umbilical hernia is carried out in the usual way. The doctor asks the patient to lie on his back, applies it to the skin in the navel area special gel and conducts research using an ultrasonic sensor.  |
| Herniography | An X-ray contrast agent is injected into the patient’s abdomen, which penetrates the hernial sac and stains it. It becomes clearly visible on x-rays. The doctor prescribes herniography when there is doubt about the diagnosis. |
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| CT scan | The study is carried out when the symptoms are unclear and doubts arise about the diagnosis. CT scan– a study that allows you to obtain layer-by-layer sections of a certain area of the body, a clear three-dimensional image. |  |
| X-ray of the stomach and duodenum with contrast | The study allows us to suspect tumor processes in the stomach and duodenum, diseases that accompany an umbilical hernia and lead to abdominal pain. | The patient is given a contrast drink - usually a barium sulfate solution. Then x-rays are taken.  |
Gastroduodenoscopy – endoscopic examination of the stomach and duodenum.  |
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Treatment of umbilical hernia in adults
Treatment of umbilical hernia in adults is only surgical. Different types of operations are used, depending on the size of the hernia and the condition of the anterior abdominal wall.Usually, surgery for an umbilical hernia, if there is no strangulation, is carried out as planned. During the first appointment, the doctor examines the patient, prescribes a preoperative examination and a date for hospitalization.
Preoperative examination in a patient with an umbilical hernia
- tests for hepatitis, HIV, syphilis;
- coagulogram - blood test for clotting;
- chest x-ray.
Types of operations for umbilical hernia
An operation aimed at eliminating a hernial protrusion is called hernioplasty. Types of hernioplasty that are performed for umbilical hernia:- Tension. The patient's umbilical ring is strengthened with his own tissue. In order to close the defect, they are pulled, which is why the operation got its name.
- Non-tensioned. To strengthen the umbilical ring, special synthetic mesh is used.
- Laparoscopic. The operation is performed without an incision, through punctures in the abdominal wall.
Tension hernioplasty
- The surgeon makes an incision and provides access to the hernial sac.
- Depending on the size hernial sac, it is either simply immersed in the stomach, or stitched and cut off.
- The umbilical ring is stitched and reinforced with adjacent tissues.
Tension-free hernioplastyThe operation is performed in a similar way, but the surgeon uses a special synthetic mesh to strengthen the navel. Subsequently, it grows into surrounding tissues.
The advantage of tension-free hernioplasty is the relatively low likelihood of relapse. The hernia occurs again on average in only 2 patients out of 100. The rehabilitation period lasts only 30 days, even for those people who play sports professionally. 
Laparoscopic hernioplasty
During laparoscopic surgery, a mesh implant is also used; it is installed through a puncture in the abdominal wall. The surgeon does not make a large incision, which significantly reduces postoperative rehabilitation time.
But there are also certain difficulties. Laparoscopic hernioplasty requires special equipment and trained surgeons. Not every hospital has this opportunity. Surgeries through a puncture are contraindicated in patients with pathologies of the respiratory and cardiovascular systems, with a large expansion of the umbilical ring.
Surgery for strangulated umbilical hernia
If an umbilical hernia is strangulated, surgery must be performed as an emergency.
The risk of strangulation does not depend on the size of the hernia - it increases the more the longer the patient does not see a doctor.
During surgery, the doctor opens the hernial sac and examines the organ that is inside. If it is not changed, then it is simply immersed in the stomach. If part of the organ is dead, it is excised. And if the doctor has doubts, he covers the organ with napkins soaked in warm saline and injects a solution of novocaine.
Rehabilitation after surgery for umbilical hernia in adults
- Usually, if the operation goes without complications, the patient is allowed to get up on the first day.
- IN postoperative period Wearing a special bandage is indicated (about a month when using mesh implants).
- On day 10-14 you can start exercising therapeutic exercises, but it is prohibited to perform abdominal exercises.
- After the operation, daily dressings are performed, the sutures are removed on the 7th day (if they do not dissolve on their own).
- For pain, painkillers are prescribed.
- The doctor may also prescribe antibiotics, vitamins, and immunomodulators.
Wearing a bandage for an umbilical hernia
The bandage is not a treatment for an umbilical hernia. It only helps, while wearing it, to correct the hernia and prevent it from being strangulated. Indications for wearing a bandage:
- After surgery for an umbilical hernia and in general for any surgical intervention when the incision passed through the navel.
- If there are temporary contraindications to surgery: acute diseases, exacerbation of chronic After normalization of the patient's condition, surgical treatment is performed.
- Serious illnesses: significant impairment of cardiovascular and respiratory systems, exhaustion, elderly age, malignant neoplasms etc.
- Pregnancy on late stages– this is also a contraindication for surgery.
The bandage is a wide belt made of elastic fabric, on the inner surface of which a special anatomically shaped pad is attached. She presses the navel and does not allow the hernia to protrude outward. The pelot can be connected to the bandage or attached to it with Velcro. Traditional methods of treating umbilical hernia
An umbilical hernia in an adult is a disease that can only be eliminated with surgery.“Spells” and gluing coins to the navel are methods that are often recommended to be used ethnoscience, - “help” only small children, since their umbilical hernia can close on its own before the age of 5. This doesn't happen in adults.
Decoctions, infusions, lotions with medicinal plants ineffective. With their help, an umbilical hernia in an adult cannot be eliminated.
Prevention of umbilical hernia
| What do we have to do? | What should you avoid? |
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During the development of the embryo, between the 6th and 10th weeks, the intestine increases in size, lengthens, and intestinal loops, which do not fit in the abdominal cavity, are pushed out of it through the umbilical ring at the site of attachment of the umbilical cord to the anterior abdominal wall. Located extraperitoneally, in the umbilical membranes, they go through a temporary stage of “physiological intestinal hernia”, and then, after completing the process of rotation, they return to the expanding abdominal cavity. If, as a result of a violation of the process of intestinal rotation, underdevelopment of the abdominal cavity or a violation of the closure of the abdominal wall, some organs remain in the umbilical cord membranes, the child is born with a hernia of the umbilical cord, or OMPHALOCELE. By the 11th week of pregnancy, normally, the intestinal loops return back into the abdominal cavity and the hernial protrusion disappears.
By the time you come for your 1st trimester screening at 11-13 weeks, in most cases this process is already complete, but it is worth remembering that until 12-13 weeks the fetal intestines can normally extend beyond the border of the abdominal cavity, and this would still be considered a physiological intestinal hernia. Protrusion of intestinal loops into the umbilical cord, which occurs during normal development, is usually accompanied by an increase in the diameter of its base by less than 7 mm.
In the case when the released intestinal contents are determined separately from the area where the umbilical cord enters the abdominal cavity and is not covered with a membrane, then such an echographic picture will be diagnostic sign already another anomaly in the development of the anterior abdominal wall - gastroschisis, even in the first trimester of pregnancy.
When calculating the risk of chromosomal abnormalities (CA) in software FMF at 11-13 weeks, although the detection of an omphalocele is indicated, it does not affect the result.
So. Omphalocele is a defect of the anterior abdominal wall in the area of the umbilical ring with the formation of a hernial sac with intraperitoneal contents, covered with an amnioperitoneal membrane. 
At the birth of a child, the omphalocele can be small, with only a small part of the intestinal loop, but it can also be large, up to 10 cm or more, including, in addition to the intestines, the liver and other organs. The incidence of small omphaloceles (up to 5 cm) is 1:5000 live births, large ones (10 cm or more) - 1:10000 live births.
Ultrasound diagnosis of omphalocele is based on the detection of a round or oval-shaped formation adjacent to the anterior abdominal wall with clear smooth contours, filled with heterogeneous contents, to which the umbilical cord is directly attached.
Omphalocele can be isolated when there are no other changes or developmental abnormalities in the fetus.
However:
- In approximately 30% of cases, a combination of omphalocele with chromosomal abnormalities is observed. According to the results of E.V. Yudina, the frequency of CA with omphalocele in the fetus in the group of patients over 35 years old was 54.5%, and in patients under 35 years old - 28%. All chromosomal abnormalities were detected only in cases of combined omphaloceles; their frequency in this group was 46.4%;
- Some children are subsequently diagnosed with Beckwith-Wiedemann syndrome;
- More than half of children with omphalocele have defects in other organs and systems. Most often these are cardiovascular defects, genitourinary system, spine, diaphragmatic hernia, skeletal dysplasia.
- Remember that up to 12-13 weeks this may be normal and wait for the results of the screening examination.
- If, according to the screening results, the individual risk of CA is low, then repeat the ultrasound in 2-3 weeks. By this time, the physiological intestinal hernia should disappear.
- If the risk of CA is high, prenatal medical and genetic counseling is in any case indicated and fetal karyotyping is recommended. Or you can choose to terminate the pregnancy.
- If an omphalocele is detected again after 2-3 weeks, even with a low individual risk of CA in the first trimester, prenatal medical and genetic counseling is indicated, fetal karyotyping is recommended, as well as a thorough assessment of the ultrasound anatomy of the fetus at 18-20 weeks to exclude combined malformations.
The method of choice for delivery is often a planned cesarean section in the interests of the fetus, although the opinions of specialists on this issue are ambiguous.
After birth, with very small hernias (up to 1.5 cm), one can hope for independent closure of the umbilical ring in a few weeks, but if after reaching three summer age the hernia does not close on its own, a decision is made to operate. Larger omphaloceles are usually operated on in the first day of life. The large size of the hernial sac requires a two-stage operation with gradual reduction of the organs into the abdominal cavity.
Kaiser et al followed the development of children operated on for omphalocele for 1-28 years and concluded that the presence isolated omphalocele is not an indication for termination of pregnancy, since subsequent development and social adaptation children proceeds without complications.
A few words about Beckwith-Wiedemann syndrome
This is a genetically determined disease that is characterized by a combination of macrosomia (rapid, hypertrophic growth), omphalocele, macroglossia (a large tongue that does not fit in the mouth), a predisposition to embryonic tumor formations and neonatal hypoglycemia (low blood sugar levels in a newborn). In addition, developmental anomalies are common ears and hemihyperplasia, where some parts of the body are larger on one side than the other.
Such children are born quite large (about 4 kg) and in the first months of life they gain significant weight and height. At birth, attention is drawn to a large tongue protruding from the mouth and a defect of the anterior abdominal wall, mainly an omphalocele.
With timely correction of hypoglycemia, accelerated growth rates gradually decrease already in childhood, intellectual development is usually not affected, and adults usually do not experience medical problems associated with this disease. But early diagnosis of Beckwith-Wiedemann syndrome is important, since in such children increased risk education various tumors, primarily Wilms tumor (nephroblastoma) and hepatoblastoma. After 10 years of age, the risk of tumor formation decreases to the general population level.
It is possible to suspect Beckwith-Wiedemann syndrome during ultrasound, but only in the third trimester with a combination of macroglossia, omphalocele and macrosomia with a normal karyotype. In the journal Prenatal Diagnostics for 2003, a description of a case of prenatal ultrasound diagnostics Beckwith-Wiedemann syndrome without omphalocele in the fetus in the third trimester of pregnancy. The presence of this syndrome was suspected when ultrasound examination at 30-31 weeks of pregnancy based on macroglossia, microrhinia, visceromegaly and macrosomia. The diagnosis was confirmed after the birth of the child.
Tell me, please, what does a physiological umbilical hernia in a fetus mean? This diagnosis was made at 10 weeks of pregnancy.
Physiological embryonic hernia is a developmental defect that is not considered a serious disorder before 10 months. If a hernia in the fetus is detected later, this indicates abnormal development. If an umbilical hernia is the only abnormality that the doctor has identified, then there is no need to worry, the intestinal loops will begin to retract on their own and the disease will go away. The combination of a hernia and omphalocele is considered dangerous. An omphalocele is an abnormality in which organs begin to develop outside the abdominal cavity. Such organs may become hypothermic and dry out, and there is also a risk of infection. The deviation often accompanies other malformations of the abdominal wall, nervous system and musculoskeletal system.
A physiological hernia in the fetus is not dangerous, but provided that its size does not exceed 1.5 cm. It is impossible to talk about the prognosis remotely, since you have to go through a lot diagnostic measures, in order to find out exactly whether this condition is normal or whether there are other developmental abnormalities.
If we talk about a physiological hernia without accompanying disorders, then it has a favorable prognosis. After birth, the baby's abdominal wall strengthens and he develops normally. Such children need to be monitored for some time, as the hernia may reappear. To prevent the recurrence of the disease in a child, you need to massage and monitor the work gastrointestinal tract, create the right diet.
Treatment is carried out surgically for up to five years. If the disease becomes more complicated, infringement appears, intestinal obstruction or inflammation, then surgery is performed immediately.
Among the vices intrauterine development Physiological embryonic hernia is quite common in children. The pathology is most often detected in boys and accounts for approximately one thousand cases per 6-10 thousand newborns, and 35% of them are premature babies.
Detection of embryo development disorders
An embryonic hernia can be detected even at the intrauterine stage of fetal development: the abdominal wall and its pathology are clearly visible on ultrasound. Another method early diagnosis– blood test of a pregnant woman for AFP (alpha-fetoprotein). Increased level indicates an abnormal development of the fetus.
However, it should be remembered that up to 13 weeks, the embryo’s intestines can extend beyond the border of the abdominal cavity and provoke protrusion of the umbilical cord. This counts physiological norm: The intestine migrates inside the umbilical cord between the sixth and tenth weeks of embryonic development. During the normal course of pregnancy, the loop of the thick and small intestine usually retracts spontaneously into the abdominal cavity.
An omphalocele, or hernia of the umbilical cord, should be distinguished from an embryonic physiological hernia. The anterior abdominal wall of the fetus is formed with a delay, resulting in physiological hernia and the umbilical cord are not completely healed. Pathological process begins in the second month of embryonic development.
If at 10 weeks the process of retraction (retraction) of the intestinal loop has not begun, then the development of the unborn baby is impaired. As a rule, omphalocele is combined with pathology of the heart, genitourinary system, skeleton, diaphragm and even brain. Multiple violations on early stage embryo growth is recorded in approximately half of the cases.
Having discovered a combination of omphalocele and internal organ defects in the fetus, the doctor will most likely suggest terminating the pregnancy. This is due to the fact that such a pathology is considered very severe and can lead to spontaneous abortion, intrauterine fetal death, the birth of a non-viable child.
Self-closing hernia
According to statistics, a congenital embryonic hernia does not pose a threat to life and health: almost all babies recover on their own. But only if the pathological formation is no more than 1.5 centimeters in size.
After the birth of a child, the abdominal wall strengthens, the intestines begin to work stably, the baby grows, becomes more active, and this also has a positive effect on the disappearance of dysfunction. You can hope for the umbilical ring to close on its own within a few weeks of birth. But this process has an age limit: if, upon reaching the age of three, the hernia has not closed on its own, the doctor decides on surgery.
If the hernia is more than 1.5 cm, then the following classification has been developed to select the method of its treatment:
- Small hernia no more than 5 cm
- Average hernia no more than 10 cm
- Large hernia more than 10 cm.
The operation can be performed during the neonatal period. This applies to small and medium hernias. Surgical treatment of a large hernia is usually performed at the age of three to five years.
What are the dangers of congenital embryonic hernias? Complications: the formation of intestinal obstruction, strangulation, inflammatory and tumor processes. In this case, immediate surgery is required.
Causes and symptoms of omphalocele
Most often, omphalocele is formed as a result of rare genetic diseases, such as Edwards syndrome (causing multiple malformations) or Patau syndrome (incurable hereditary chromosomal disease). In addition, pathology of the abdominal wall can develop against the background of infection during pregnancy, taking medicines, smoking, alcoholism. The disease is an indication for elective surgery caesarean section, which in the absence emergency situations can be performed at 36 weeks.
Omphalocele disease can be complicated or uncomplicated. Uncomplicated on visual examination resembles a tumor not covered by skin. The transparent umbilical ring, in the area of which the formation is clearly visible, allows you to see what is in the hernial sac: intestinal loops and parts of the internal organs.
The photo shows a newborn with a physiological embryonic hernia
In turn, with a complicated omphalocele, the membranes of the hernial sac rupture, and this happens both in the womb and at the time of birth. As a result of organ prolapse, a fatal infection of the peritoneal cavity occurs.
It is not difficult to understand what an omphalocele is: at birth, the baby is found to have a hernia protruding from the umbilical opening, measuring from 4 to 12 centimeters, the sac of which contains either only the intestines (with a mild course) or most of the internal organs (with a severe course). As a rule, the disease is combined with other multiple malformations.
Surgical treatment of omphalocele
The only way to get rid of the disease is through surgery. The surgeon closes the defect as soon as possible after birth. Before the operation, concomitant defects of the heart, lungs, liver, kidneys, and other internal organs are identified.
If the omphalocele is small, then it is operated on once, twisting the umbilical cord. But when large sizes bulging surgery very difficult to carry out. In this case, due to a violation normal development The fetal abdomen of a newborn is so small that it is first necessary to expand its volume with an implant.
Probability fatal outcome operations in case of detection accompanying defects internal organs reaches 20 percent. If no anomalies of other organs are detected, the prognosis surgical treatment favorable.
This video describes the results of surgical treatment of a congenital defect. diaphragmatic hernia The child has:
Umbilical hernia is a pathology manifested by a round or oval protrusion in the area of the umbilical ring, which increases when the child screams or is restless.
To make it clearer why an umbilical hernia appears, let’s touch a little on the anatomical and physiological features of the umbilical region of the fetus and newborn.
The baby's belly button is formed at the site of the opening of the umbilical ring through which the umbilical cord passed. After ligation of the umbilical cord, during the first 5 days the remainder of the umbilical cord dries out and falls off, and during the first month of life the umbilical cord vessels completely close. The area of the umbilical ring tightens, scars and becomes covered with a fold of skin.
If the umbilical ring does not close completely (which is observed in some newborns), fragments of the abdominal organs, such as the greater omentum, peritoneum, and intestinal loops, may protrude through its opening (weak spot), under the skin. This is an umbilical hernia.
Symptoms of an umbilical hernia
When small in size, a hernia may appear only during crying, with anxiety or straining. With a large hernia, a swelling is constantly visible in the navel area, which increases during crying.
The size of an umbilical hernia can vary from a small pea (3-5 mm) to a large plum (5 cm or more). Characteristic feature is that when pressed, the protrusion is pushed back, and a gurgling or rumbling sound may be noted.
Predisposing factors for the development of umbilical hernia
This is all that leads to weakness of the rectus abdominis and abdominal muscles. These are prematurity and low birth weight (low birth weight babies), since this category of children is characterized by congenital weakness of connective tissue and muscles. In older children, frequent constipation, flatulence, and prolonged severe crying can lead to the appearance of a umbilical hernia.
Pregnancy pathology can also cause a hernia. Various infectious diseases, harmful chemicals, environmental factors can affect the formation and development of connective tissue and muscles of the fetus. Which can lead to disruption of the formation of the structure of the umbilical ring, and subsequently to an umbilical hernia.
In some cases, umbilical hernias in children may appear for no apparent reason.
Most often, small hernias (up to 1 cm) occur. Such hernias can go away without special treatment by the age of 3, when the abdominal muscles become stronger and more toned.
Even with small hernias, observation by a pediatrician or surgeon is mandatory, as there is a risk of strangulation of the hernia. To strengthen muscles, you should regularly do massage and gymnastics.
Treatment of umbilical hernia
- Place your baby on his stomach frequently;
- Make sure that your baby has regular bowel movements and prevent constipation and flatulence;
- Do not let your child scream profusely and hysterically;
- Do strengthening massage and gymnastics. The basic techniques are not difficult to learn, after which the mother can do massage and gymnastics on her own.
Massage technique for umbilical hernia
The massage begins with light stroking movements on the baby’s stomach in a clockwise direction (along the intestines). To do this, place your palm on your stomach so that the navel is located in the center of the palm and turn your hand clockwise. Another technique for strengthening the abdominal muscles is to place your hands on the baby's sides (at the level of the obliques) and use gentle stroking movements from below (from the back) to the navel. Lightly pinching around the navel helps strengthen the muscles (also done clockwise), tapping with your fingertips in the navel area - these are the basic techniques. Hands should be warm during the massage. It is better to massage the abdomen 30-40 minutes before meals or 1.5-2 hours after on a hard, flat surface. Begin massage after healing umbilical wound.
No manipulations are carried out in the umbilical ring itself! All this is done 1-2 times a day, increasing the duration as the baby grows.
To better master massage and gymnastics techniques, ask a massage therapist or nurse show them, in this case you will be sure that you are doing everything correctly.
Regarding the reduction of a hernia using a coin and a patch, this method is currently not used due to high risk umbilical wound infection. Reduction of the hernia followed by fixation with an adhesive plaster should be carried out by a doctor. Now they produce special hypoallergenic patches for the treatment of umbilical hernia.
In cases where the size of the hernia is more than 2 cm, there is an increase in its size and it does not disappear on its own by the age of 5, surgery is indicated.
A hernia in an infant may require emergency assistance - in cases where the hernial sac becomes painful, dense, and cannot be reduced. These symptoms may indicate a strangulated umbilical hernia. This is very dangerous condition, since part of the intestine gets stuck in the umbilical ring, which can lead to intestinal obstruction and necrosis of part of the intestine. In case of infringement they do emergency surgery.
Many parents try to try all methods to help their baby. Yes, it is quite popular conspiracy of umbilical hernia in babies. Well, if you were recommended a good one traditional healer and you really believe that he will help you, then why not talk about an umbilical hernia in a baby. Just don’t forget about traditional methods treatment. And focus on strengthening the abdominal muscles and preventing diseases that contribute to the progression of the hernia (constipation, flatulence, rickets and others).
Inguinal hernias in children
In addition to umbilical hernia, inguinal hernias are also common in children. Inguinal hernia in newborns is rarely diagnosed. But it should be noted that in premature babies the risk of developing this pathology is much higher. An inguinal hernia in an infant is a protrusion in the groin area.
This pathology is most often associated with non-closure of the vaginal process of the peritoneum. In boys, an inguinal hernia is more common, since they also have a cord that accompanies the testicles and spermatic cord on the way to the scrotum during the prenatal period, normally it should become obliterated (overgrown). If this does not happen, then this canal becomes a weak point and part of the omentum and intestinal loops may protrude into the free space. In girls, the pathology is less common, but in them, in addition to intestinal loops and omentum, the hernial sac can get oviduct with an ovary (this is very dangerous).
How does an inguinal hernia manifest?
A tumor-like formation appears in the groin area, which becomes more noticeable when the child is restless and disappears when calm state. In boys, half of the scrotum may be enlarged on the side of the hernia. Girls may experience swelling of the labia.
With gentle pressure on the protrusion, it is easily reduced into the abdominal cavity, usually with rumbling (if the contents are intestinal loops).
A unilateral inguinal hernia is more common.
If a baby has a hernial protrusion in the groin area (regardless of the child’s age), then you should immediately contact pediatric surgeon. You should know that inguinal hernias do not go away on their own; they can only be treated surgically.
Inguinal hernia strangulation
One of dangerous complications inguinal hernia is its infringement. As a result of strangulation, compression of the contents of the hernial sac occurs with the development of circulatory disorders in this area, which can lead to necrosis (tissue death).
In boys, intestinal loops are more often strangulated, in girls - the ovary. When pinched, the child experiences paroxysmal, growing anxiety. The swelling persists outside of an attack of anxiety and does not reduce with pressure. Subsequently, swelling increases and redness appears. If the hernia does not correct itself and the child is not helped, intestinal obstruction, peritonitis, and necrosis of strangulated organs may develop. Infringement may be accompanied general symptoms- increased body temperature, vomiting, refusal to eat, anxiety.
In girls with strangulation, emergency surgery is performed due to the risk of compression of the ovaries. Since even short-term strangulation of the ovaries leads to the death of eggs, which can subsequently affect the reproductive system.
In the case of a strangulated hernia in boys (when admitted to the hospital with a short history of strangulation), it is possible to use a set of conservative measures that are aimed at relaxing the muscles, reducing swelling and self-reduction of the hernia.
If reduction occurs and the condition improves, it is recommended to perform a planned surgical intervention.
If there is no effect from conservative measures, as well as when the strangulation has been long-standing and there are symptoms of pressure from the contents of the hernial sac, emergency surgery is indicated.
Treatment of inguinal hernias
Currently, it is recommended to do planned surgical treatment inguinal hernia immediately after diagnosis. In children early age the operation is performed after 6 months of life (if there are no signs of strangulation), but the child must be observed by a surgeon, and the parents are informed about the risk of strangulation.
Umbilical hernia in newborns photo
