Umbilical hernia

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Written by Tong Peng
Pediatrics
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What should I do if my baby's umbilical hernia doesn't go away?

Umbilical hernia in children is mainly caused by an unsealed navel ring. Its treatment should be based on specific clinical symptoms and age. If the hernia does not retract, it can be treated conservatively or surgically. Conservative treatment involves returning the hernia contents to the abdominal cavity and using an object the size of a coin, wrapped externally with gauze, to hold it in place and prevent movement. Generally, umbilical hernias in infants under six months can be cured with conventional treatment methods, and the treatment effect is very good. However, if the diameter of the navel ring exceeds 1.5 cm after the age of two, surgical treatment should be considered. For children over five years of age who still have symptoms of an umbilical hernia, conservative treatment is ineffective, and surgery should be performed as soon as possible. Umbilical hernias are a common condition, but not serious, requiring only dynamic observation and timely medical treatment if severe.

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Written by Zeng Hai Jiang
Pediatrics
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How does an umbilical hernia gradually improve?

Umbilical hernia refers to a protrusion formed by abdominal contents through the weak area of the umbilicus. After the umbilical cord falls off in the neonatal period, the umbilical scar area, due to the phase when the umbilical cord passes through the abdominal wall during fetal life, creates a congenital separation in the abdominal wall. In infancy, the abdominal muscles on either side do not completely close at the midline, leaving a defect and forming the umbilical ring. When crying, coughing, or struggling increases intra-abdominal pressure, the abdominal contents gradually push outwards through the umbilicus, forming an umbilical hernia. Most umbilical hernias can heal on their own within one year through the contraction of the umbilical fascial ring. Therefore, unless incarceration occurs, observation and waiting with non-surgical treatment can be adopted to promote healing before the age of two.

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Written by Zhang Ai Min
Pediatrics
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Symptoms of infant umbilical hernia

Infant umbilical hernia refers to a large protrusion at the navel of an infant, generally composed of the remaining umbilical cord and a part of the intestine. Typically, if the protrusion is not very large, such as less than one centimeter, it usually does not include the intestines. However, if it is particularly noticeable and large, there might be protrusion of the intestines, hence the area may feel bloated when touched. An infant umbilical hernia may cause localized accumulation of the intestines, and some children might cry and show signs of pain while feeding. However, generally speaking, most umbilical hernias do not have obvious symptoms, and there is no need for excessive worry. As the child ages, there is a possibility of improvement, and the hernia might heal on its own.

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Written by Zhang Peng
General Surgery
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Can an umbilical hernia heal itself?

Umbilical hernias can heal on their own, but we need to choose the appropriate method during the treatment process. Generally, if the umbilical hernia occurs before the age of two, we can choose a coin larger than the umbilical ring or a flat board, wrap it in gauze to press against the umbilical ring, and then use tape to secure it to prevent it from moving. In such cases, the hernia may heal on its own. During the observational treatment of an umbilical hernia, it is also important to prevent the child from engaging in vigorous activities or crying. If the diameter of the umbilical ring exceeds 1.5cm after the age two, we recommend choosing surgical treatment. Generally, if the umbilical hernia has not healed by the age of five, we actively recommend opting for surgical treatment. If the child's improper lifestyle can cause aggravation or even rupture of the umbilical hernia, emergency surgery is required in such cases.

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Written by Zhang Peng
General Surgery
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Can umbilical hernia be treated with moxibustion?

Umbilical hernia is fundamentally a surgical condition. The effectiveness of moxibustion in treating umbilical hernia is generally not very clear, and currently, there is no scientific basis to prove that moxibustion can cure umbilical hernia. Typically, umbilical hernias occur when the umbilical ring does not completely close. In children under six months, a conservative treatment approach is usually chosen. This can involve using a coin or cardboard larger than the umbilical ring, wrapping it to press against the ring, and securing it with adhesive tape to prevent movement. Most patients under six months old can heal naturally. For umbilical hernias, if the child is over two years old and the umbilical ring is still larger than 1.5 cm, surgical treatment is recommended. Moxibustion treatment does not offer significant benefits in the treatment of umbilical hernias. Therefore, as umbilical hernia is a surgical condition, it is advised that patients undergo surgery if their condition permits.

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Written by Ma Xian Shi
General Surgery
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Difference between umbilical hernia and abdominal linea alba hernia

Umbilical hernias occur when the hernia sac protrudes through the navel ring, commonly developing around the navel area. Linea alba hernias occur between the xiphoid process and the navel, in the area referred to as the linea alba. The hernia that protrudes in this specific region is called a linea alba hernia. Anatomically, these two types of hernias are distinct, so they can be identified based on their anatomical location. Additionally, color ultrasonography can be used to detect the position of the hernia sac. If it is located in the upper abdomen, above the navel, it is generally identified as a linea alba hernia. If it is situated above or below the navel, it may be considered an umbilical hernia. Ultrasound can help differentiate between an umbilical hernia and a linea alba hernia.

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Written by Tang Da Wei
General Surgery
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How to press back an umbilical hernia?

Umbilical hernias are generally more common in newborns, primarily because the umbilical ring has not yet completely closed. In children, lumps appear in the navel area when they cry or when abdominal pressure increases. To address an umbilical hernia, first massage the area around the belly button, then gently return the hernial sac to the abdominal cavity with both hands. After returning the hernia, secure it externally with a hernia belt. This can effectively prevent the recurrence of the umbilical hernia. Typically, through conservative treatment, which involves this method of binding for about one to two months, the patient’s umbilical hernia can heal on its own.

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Written by Zhang Peng
General Surgery
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Can an umbilical hernia be massaged back into the abdominal cavity?

Umbilical hernias can be massaged back into the abdominal cavity, but if the hernia suddenly becomes hard, or increases in size significantly and cannot be reduced promptly, careful observation is needed to determine if incarceration has occurred. If incarceration persists for too long, it might lead to intestinal necrosis or rupture. Generally, umbilical hernias can self-heal within six months through conservative treatment. If the diameter of the umbilical ring still exceeds 1.5 centimeters after the age of two, it is advised to opt for surgical treatment. For patients over five years old, surgery is recommended under any circumstances. In conservative treatment of umbilical hernias, the most common method involves using an object larger than the umbilical ring, such as a coin or cardboard, wrapped and fixed to the umbilical area, then secured with adhesive tape to prevent movement. Generally, this treatment method is quite effective.

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Written by Zhang Peng
General Surgery
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Does an umbilical hernia affect a baby's gastrointestinal system?

Umbilical hernia generally does not affect a baby's gastrointestinal tract, but we need to avoid the hernia becoming trapped or even rupturing. Once an umbilical hernia has formed, the hernial sac may contain abdominal omentum or possibly intestines. If the intestines become trapped, this can lead to necrosis of the intestines. Generally, patients may experience nausea, vomiting, or even bloody stools. Therefore, umbilical hernias can usually be treated conservatively within the first six months. If the diameter of the umbilical ring is still greater than 1.5 cm after the age of two, we recommend early surgical intervention, as only surgical treatment can cure it. In the treatment process of an umbilical hernia, the conservative treatment methods adopted mainly involve using a coin or a flat board larger than the umbilical ring, wrapping it to press against the umbilical ring, and then securing it with wide tape to prevent movement.

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Written by Zhang Peng
General Surgery
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Is an enlarging umbilical hernia dangerous?

Umbilical hernia is not more dangerous as it gets larger; rather, the larger the umbilical hernia, the less likely it is to heal on its own. During the observation of an umbilical hernia, we need to be vigilant about the possibility of incarceration or rupture. This condition arises because the umbilical ring does not heal and close properly, typically presenting as a raised lump at the navel, which can recede on its own or disappear. Generally, umbilical hernias can heal on their own within the first six months with proper treatment. However, if the diameter of the umbilical ring exceeds 1.5 cm after the age of two, surgical treatment is required. In any case, if the patient is over the age of five and the hernia is still present, surgery is the chosen treatment. In treating umbilical hernias, our conservative approach involves using a coin or a flat board larger than the umbilical ring, wrapping it, and securing it at the umbilical area with adhesive tape to prevent movement, which generally produces good results.