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Umbilical hernia
Is an umbilical hernia in infants serious?
Infant umbilical hernia is caused by a weak abdominal wall around the navel, which is underdeveloped, leading to protrusion. This is prone to happen when intra-abdominal pressure is high. Therefore, it's usually sufficient to avoid intense crying in children and actively treat gastrointestinal diseases without special treatment. This is because 80% of infants will naturally see the hernia ring narrow, or even close by itself by the age of two, leading to healing. Only a few children, if the hernia ring diameter is large, more than 2 cm, or if the umbilical hernia is still evident after the child turns two, will require surgical treatment.
What are good remedies for infant umbilical hernia?
Umbilical hernia in infants is caused by congenital underdevelopment of the abdominal muscles, forming a bulge beneath the skin due to abdominal distension protruding from the umbilicus. In fact, it usually does not require special treatment. Most umbilical hernias will gradually narrow and shrink within the first year after birth as the infant's nutrition and physique improve and the abdominal muscles develop, typically leading to natural closure with a very good prognosis. In daily care, it is important to prevent the child from crying loudly, especially when the child has gastrointestinal diseases and increased intestinal gas, which should be actively treated to minimize the herniation and to reduce it back when it does protrude. With such care, the chances of natural healing increase. However, if the child is over four years old and the hernia sac is still relatively large, surgical repair might be necessary.
Is hot compress useful for umbilical hernia?
In cases of umbilical hernia, applying heat generally has no effect. For infants, it is often acceptable to observe conservatively until the child is about two years old. Adhesive tape therapy can be used in this period. By the age of two, the umbilical ring in most children will close on its own. For those over two years old with an umbilical ring diameter still greater than 1.5 cm, surgery should be considered. For patients over five years old, it is generally recommended to undergo surgery sooner rather than later. In adults, the causes of umbilical hernias are mainly due to factors such as pregnancy, excessive fat in the greater omentum, chronic coughing, cirrhosis with ascites, etc., which increase abdominal pressure. Incarceration can occur, involving either the greater omentum or the small intestine, and surgery is usually the chosen treatment method, either through traditional tissue repair techniques or open tension-free hernia repair. In some cases, laparoscopic umbilical hernia repair may be chosen when necessary.
Does infant umbilical hernia require surgery?
If an infant's umbilical hernia still shows obvious protrusion after two years of age, surgery is required. Another scenario that necessitates surgery is if the diameter of the hernia ring of the infant's umbilical hernia is relatively large, such as more than 2cm, as generally, it cannot heal by itself. However, over 80% of infant umbilical hernias do not require special treatment or surgery. As age increases and nutrition is maintained, the subcutaneous tissues around the abdominal wall's umbilical hernia ring can repair and narrow, leading to healing.
How is umbilical hernia treated?
In treating umbilical hernias, we need to consider both the age of the patient and the size of the hernia specifically caused. Generally, children under the age of two do not require surgery. Typically, we consider using a coin or cardboard larger than the umbilical ring, wrapping it up, pressing against the umbilical ring, and securing it with adhesive tape to prevent movement. Most can close by themselves and heal. For children over two years old, if the hernia is still larger than 1.5cm, surgical treatment should be considered. In adults, traditional tissue repair methods are generally used, or an open umbilical hernia tension-free repair. The repair can be placed in front of the muscle or can use a hernia ring filling method. For most patients, if there is an opportunity for minimally invasive treatment, laparoscopic umbilical hernia repair can be selected. This method generally involves a smaller incision and can preserve the navel, reducing the chance of incision infection, and is particularly suitable for obese patients.
Is it normal for there to be moving gas inside an umbilical hernia?
It is abnormal for there to be movement of gas within an umbilical hernia. This could potentially indicate that the contents of the hernia include a part of the intestine. When excessive intestine is present within the hernial sac of an umbilical hernia, it can easily lead to the movement of gas as it moves through the intestine. This condition is relatively common in clinical settings, and it is also used as a symptom to diagnose the possibility of an umbilical hernia. Therefore, when there is movement of gas observed in an umbilical hernia, it is crucial to reposition the hernia back into place using massage and other standard techniques to avoid prolonged entrapment of the intestine, which can lead to ischemic necrosis and the possible formation of an incarcerated hernia. This condition should be actively treated to prevent complications.
How long does it take for an infant umbilical hernia to heal?
Infant umbilical hernia is caused by congenital weakness of the umbilical and abdominal regions, resulting in protrusion of the navel. Generally, it does not require special treatment. This is because up to 80% of infant umbilical hernias will gradually decrease in size as the child ages and physically develops, and the hernial ring may even close, thereby healing naturally. Surgery is usually chosen only if the diameter of the hernia ring is too large, especially if it is more than 2 cm, or if the child is over two years old and still has a noticeable umbilical hernia. Before this, it is usually advisable to avoid situations that could increase abdominal pressure in the child, such as preventing prolonged and intense crying. If the child has gastrointestinal symptoms, they should be treated promptly and actively to prevent repeated protrusion of the umbilical hernia.
What does it look like after an umbilical hernia is healed?
After umbilical hernia occurs, if it is cured and the wound heals, there is no difference from normal. There will be no lumps protruding from the abdominal wall. In principle, surgical treatment is often required after umbilical hernia occurs, as the likelihood of natural healing is small. The surgery mainly involves a tension-free umbilical hernia repair, which includes suturing the hernia ring and generally reinforcing it externally to ensure that the hernia does not recur. After the umbilical hernia is cured, the patient's navel will be flat with no protruding lumps, and there will be no incarceration of the hernia or compression of the intestines, which could cause gastrointestinal symptoms.
Will an umbilical hernia get bigger as it grows?
Umbilical hernias may increase in size, particularly in middle-aged, obese women who have been pregnant multiple times, have excessive fat in the greater omentum during pregnancy, or have chronic conditions such as persistent coughs, which can cause continuous increased pressure in the abdominal cavity. This may lead to the gradual enlargement of the hernia sac in an umbilical hernia, and it is very prone to becoming incarcerated. The contents of the incarceration might include the greater omentum or the intestines, particularly the small intestine. Once incarceration and strangulation occur, it is generally recommended that adults with umbilical hernias undergo surgery as soon as possible, with emergency surgical treatment needed in cases of incarceration. Traditional surgical methods include tissue suture repair or open umbilical hernia tension-free repair. If a minimally invasive option is available, it is generally less traumatic and particularly suitable for obese patients.
Why can't you cry with an umbilical hernia?
In children with umbilical hernia, crying can easily lead to an increase in intra-abdominal pressure. As the intra-abdominal pressure increases, gas in the intestines and mesentery can easily protrude through the unclosed umbilical ring, thereby exacerbating the symptoms of the umbilical hernia. In severe cases, this could lead to serious complications such as incarceration of the hernia. Therefore, in addition to not crying, children with an umbilical hernia should also avoid constipation, coughing, and vigorous activities that could increase intra-abdominal pressure, in order to prevent worsening of the hernia symptoms. In daily life, their diet should be light and easy to digest.