Umbilical Hernia: Symptoms, Causes, Treatment
الفتق السرّي
An umbilical hernia is tissue protruding through a weakness near the navel. Many childhood hernias close with growth, whereas adults need surgical assessment. Severe pain or vomiting with a trapped lump may signal an emergency.
What is Umbilical Hernia?
The bulge may contain fat or bowel and become more apparent with crying, coughing or straining. Childhood and adult hernias behave differently; advice to await closure in a child should not automatically be applied to a new adult hernia.
Related reading: Inguinal Hernia.
Symptoms
A swelling around the navel may decrease when lying down. Childhood hernias are often painless, while adults may feel discomfort. A lump becoming painful, firm, discoloured or no longer reducible needs prompt assessment.
Causes
In infants, the opening for the umbilical cord may not close completely after birth. In adults, weakness combined with abdominal pressure allows tissue to protrude. Repeated pregnancies, obesity and abdominal fluid accumulation can contribute.
Risk factors
Hernias are common in infants, particularly after premature birth or low birth weight. Adult risk factors include obesity, repeated pregnancy and ascites. Symptoms, size and anaesthetic risk matter alongside these factors when planning surgery.
Diagnosis
Examination usually identifies the hernia and defect. Imaging may help when the diagnosis is uncertain or complications are suspected. The muscle opening and visible bulge are different measurements, which can influence follow-up and repair decisions.
Treatment
Many symptom-free childhood hernias are observed until age four to five; persistence, pain or complications may require repair. Adults discuss surgery and its approach, although observation may suit selected small, minimally symptomatic hernias. Mesh use depends on age and individual circumstances.
Complications
Contents may become trapped, and strangulation can interrupt their blood supply, requiring emergency surgery. These complications are uncommon in children but possible. Recurrence and operative risks depend on the repair and general health.
Prevention
Coins or strapping do not close the opening and may damage skin. Weight management and treatment of raised abdominal pressure can help overall care but do not repair an existing hernia. Never force a painful lump back inside.
When to see a doctor
Seek emergency care for sudden severe pain with a trapped hernia, vomiting, skin discolouration, or abdominal swelling with inability to pass gas. Arrange assessment for any new or growing bulge and keep a child’s follow-up appointments even without pain.