What is an umbilical hernia?
An umbilical hernia is a protrusion of the peritoneum through a weak spot or opening in the abdominal wall. This bulge is in the navel. Complaints of an umbilical hernia are often shown as any discomfort, an aching or burning sensation and / or pain in that area.
A hernia never disappears spontaneously and can tend to be larger. That can then start giving more complaints. Occasionally, it may happen that a breakage pinched. That involves a lot of pain. An emergency surgery is needed.
A rupture of the abdominal wall always consists of three elements, namely, the breakage port, the hernial sac and fracture content. The rupture port is the defect in the abdominal wall. The hernial sac is the projection that comes out through the gate. The fracture content is the one that is in the hernia sac. This is near the navel rupture usually fat, but may also be the intestine. The danger of a rupture in the abdominal wall that the guts in the hernia can become trapped and thus may die (necrotiseren). With smaller ports fracture is more likely to have here.
An umbilical hernia arise because there is a defect of the abdominal wall at the area of the navel. This defect may be congenital or acquired.
Congenital
At the location of the umbilical cord is a small defect of the abdominal wall which is not covered with skin. This is usually not serious. The hernia usually closes in the first three years of life itself. The risk of entrapment is very small. If the fracture is not closed after three years there may still be needed surgery. In particular, in girls, this is of importance. If the umbilical hernia is not corrected, there is a risk that the rupture is greater in pregnancy.
Acquired
Acquired navel come fractures later in life by increasing the pressure in the abdominal cavity, or by prolapse of the abdominal wall. Causes of increased pressure in the abdominal cavity include pregnancy, obesity, excessive coughing or COPD much heavy lifting. The hernial sac is made up of the peritoneum and the gate breakage often consists of fat, but may also consist of intestine. In certain diseases may also increase the pressure in the abdominal wall, for example in cirrhosis. This produces often fluid in the abdominal cavity (ascites), so that the pressure in the stomach also increases. The hernia sac then consists of peritoneum and its contents from ascites.
Physical examination should be given on how big the hernia, the size of the hernia sac is and what the fracture content. Furthermore, it will examine whether the fracture is reponibel. Attempting to stop back fracture contents into the abdominal cavity. If successful, the break reponibel. If the patient coughs or squeezes the hernia sac to break content will come out again. If the fracture is not reponibel contents, the intestine can sit pinched and is an acute surgery in order to prevent intestinal dies.
Indications for umbilical hernia surgery:
- Strangulated hernia: direct operations
- Aches and pains
- Cosmetically
- Close primary. That means look up the fracture port, the hernial sac with the rupture stop contents back into the abdominal cavity (unless it is fat, it is deleted), and the fracture gate shut attach. This is only to fractions smaller than 1 cm.
- Mesh. This is a plastic mat which is sutured at the site of the fracture. It can also be glued in it with a special tissue glue. These operations often take place on an outpatient basis, unless this can not be due to underlying disease.
- There is always a chance that the break comes back (10%)
- Wound infection
- Bleeding