WHAT IS AN UMBILICAL HERNIA?
Hernias developing in the navel region are called umbilical hernias. Umbilical hernias protrude through the umbilicus or in its close vicinity and can be of varying sizes ranging from the size of a nut to the size of an orange. Umbilical hernias account for 5 to 10 percent of hernias.
WHY DO THEY DEVELOP?
The umbilicus is congenitally a weak area for the hernia to protrude. The umbilicus is the insertion point of the blood-supplying cord in the abdominal wall, transmitting blood from the mother to the fetus in the intrauterine period. It closes completely within a few days after birth. If appropriate closures do not occur, umbilical hernias may develop in children. Also, in adulthood, strain around the umbilicus may cause umbilical hernias to develop and protrusion of the hernia may occur during bending, leaning forward, and performing heavy physical activities due to the strain in the area. Additionally, obesity and rapid weight gain and loss are factors generating strain on the abdominal wall. These factors may cause umbilical hernias. Chronic constipation and coughing can also cause the development of umbilical hernias.
IN WHOM ARE UMBILICAL HERNIAS THE MOST COMMON?
Umbilical hernias are more common in women and most often noticed by the patient during pregnancy. Pregnancy generates a high intra-abdominal pressure, facilitating the development of umbilical hernias. When the uterus enlarges during pregnancy; it strains the weak area on the abdominal wall through the umbilicus, leading to the development of hernia.
WHAT ARE THE SYMPTOMS?
Pain in the umbilicus and swelling that can be seen from outside
HOW IS IT DIAGNOSED?
Diagnosis is made based on the findings obtained in the physical examination. If the diagnosis cannot be confirmed, ultrasonography is performed.
WHAT IS THE TREATMENT?
Surgical intervention is necessary for treatment. As with inguinal hernias, patches are used in the repair of umbilical hernias. Both open and laparoscopic surgery techniques are used today. Selection of the technique may vary depending on the preferences of the patient and the surgeon. If the hernia is small (smaller than 3 cm of diameter), open surgery may be preferred. When the patient would like to return to work and the daily life rapidly, when the umbilical hernia is large, and when there are esthetic concerns, I prefer laparoscopic surgery. I do not prefer the laparoscopic method in small hernias because I do not find it feasible to create three openings on the abdominal wall for such a small lesion and due to the cost of the mesh to be used for patching the hernia. The patient can return to normal daily life on an average of 7-10 days and can start running at a slow pace after two weeks following the surgery. We advise patients to avoid from lifting heavy objects and moving suddenly early after the surgery.
Recurrence rates are as low as 2-3% today owing to the use of patches in both laparoscopic and open surgery.
IF LEFT UNTREATED, WHAT TYPES OF HEALTH PROBLEMS MAY OCCUR?
When umbilical hernias grow, strangulation risk increases. The risk of strangulation is higher in umbilical hernias compared to other hernia types. Therefore; even if the hernia is small, it would be prudent to repair the umbilical hernia. When a previously reducible hernia cannot be reduced any more by reaching out or pushing it inward manually, local pain and redness and strangulation occur. Strangulation is an emergency. Strangulation causes gangrene in the intestine, infections, and sepsis.
WHAT ARE THE SYMPTOMS OF UMBILICAL HERNIA?
- Swelling Around the Navel.
- Pain Upon Strain Over the Umbilicus.
- Difficulties in moving, bending, or straightening.
- Later difficulties in walking.
HOW IS A HERNIA DIAGNOSED?
- The diagnosis of inguinal hernias is usually made during the physical examination. Ultrasound or MRI may sometimes be needed if pain occurs before swelling.
HOW ARE UMBILICAL HERNIAS TREATED?
- Inguinal hernias can be treated with surgery. Surgery can be performed by laparoscopy or using the open method. Non-operative treatment methods result in treatment failures.