Why can't you cry with an umbilical hernia?

Written by Dong Xian Yan
Pediatrics
Updated on December 06, 2024
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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.

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Written by Zhang Xian Hua
Pediatrics
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Does an infant umbilical hernia require surgery?

Umbilical hernias in infants do not always require surgery; only a small portion necessitates it. Surgery is needed mainly if the child is over two years old and still has a noticeable umbilical hernia, or if the hernia's ring diameter exceeds 2 cm. In these cases, the chances of natural healing are slim, and surgical intervention to remove the hernia sac and repair the abdominal wall defect may be necessary. In other cases, 80% of umbilical hernias can heal by the age of two as the abdominal muscles strengthen and develop with age, often causing the hernia ring to narrow and close on its own, achieving healing without any additional treatment. The previously used method of compressing the hernia with a hernia belt has been proven ineffective and is no longer employed.

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Written by Li Chang Yue
General Surgery
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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.

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Written by He Zong Quan
General Surgery
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Does pressing on an umbilical hernia hurt?

Umbilical hernias often occur because there is a weak spot near the navel and a defect in the abdominal wall, allowing abdominal contents to protrude through this weak spot and form a lump on the surface. If the hernia is not strangulated, the contents can be reduced when the patient lies flat, causing no obvious symptoms. However, if the protruding contents cannot be reduced, there may be strangulation or the hernial ring may be too small. Pressing on the protruding lump at this time may cause pain. This pain generally becomes more pronounced the longer the protrusion persists. Of course, if the hernia is completely strangulated, causing circulatory problems, the pain may significantly decrease, but this does not indicate an improvement in condition. Therefore, if an umbilical hernia becomes painful upon pressing, surgical treatment should be considered to avoid complications.

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Written by Zhang Xian Hua
Pediatrics
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Treatment methods for infant umbilical hernia

Infant umbilical hernia is caused by a congenital weak abdominal wall around the navel, leading to protrusion. It generally does not require special treatment methods. As long as care is taken to avoid the child's intense or prolonged crying, actively treat gastrointestinal diseases to prevent increased abdominal pressure that could lead to protrusion, no special treatment is usually necessary. This is because 80% of children with umbilical hernias will see their hernia rings gradually shrink or even close as they grow older, typically by the age of two. Surgical treatment might only be needed if the hernia ring is very large, such as more than two centimeters in diameter, or if the obvious umbilical hernia persists after the age of two.

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Written by Zhang Peng
General Surgery
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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.