In the umbilical hernia, the intestine or fat tissues extend to the place where the umbilical cord connecting the mother and the baby passes through the small opening in the abdominal cavity during the period in the mother's womb. Umbilical hernias in babies are very common and harmless. Usually, the hernia closes spontaneously within the first two years without any surgical intervention and treatment, very rarely, the closure process continues until the fifth year of age. Surgical intervention may be required in umbilical hernias that are still not closed by the age of four. In addition, umbilical hernia is a health problem that can be seen in adults, and umbilical hernias in adults often require surgical intervention.
What are the Symptoms of Umbilical Hernia?
The most typical symptom of umbilical hernia seen in babies is the protrusion of the belly button when the baby cries. Adults have different symptoms. Depending on the pain caused by the structures pushed out of the navel opening, it may be difficult for the person to walk and perform daily activities. There is a permanent and painful swelling in the area where the belly button is located, which can be easily noticed from the outside. In some cases, an umbilical hernia does not cause any symptoms that can be noticed by the person. If the hernia is in a size that can easily find a place in the navel cavity, there may be no visible swelling, although there is pain. If the hernia is very small, sometimes the intestines may enter (suffocate) this area and cause severe pain in the patient, and a picture called hernia suffocation, which can lead to death, may occur. The larger the umbilical hernia, the higher the risk of hernia strangulation. It also carries a much greater risk of strangulation compared to other types of hernias. For this reason, umbilical hernias seen in adulthood should be treated, even if they are small.
What are the Causes of Umbilical Hernia?
There are some risk factors that increase the likelihood of umbilical hernia in babies. Conditions such as prematurity and low birth weight and delivery, and incomplete closure of the opening through which the umbilical cord passes between the abdominal muscles are the most important of these. In adults, the most important cause of umbilical hernia is too much pressure on the area where the abdominal muscles are weak. Factors causing this pressure are being overweight, having undergone abdominal surgery, frequent pregnancy, multiple pregnancy, excessive fluid accumulation in the abdominal cavity, and persistent and severe coughs. At the same time, sudden bending over, doing heavy sports, rapid weight gain and loss and chronic constipation can also be counted among the factors that cause umbilical hernia as they increase intra-abdominal pressure. Umbilical hernias are more common in women than men due to pregnancy.
How Is Umbilical Hernia Diagnosed?
Physicians often refer to a physical examination to look for the presence of an umbilical hernia in infants or adults. During this examination performed by the physician, the umbilical hernia can be detected easily, and at the same time, it can be checked whether the hernia has been pushed back into the abdominal cavity or whether it is stuck in the area. The presence of compression can cause serious complications by stopping the blood circulation in the herniated part. For this reason, it is of great importance to investigate the existence of such a condition after the diagnosis of hernia. Symptoms of this condition, called a strangulated umbilical hernia, include fever, constipation, severe abdominal pain, tenderness, nausea and vomiting, redness and discoloration, and feeling of a bulging lump in the abdomen. During the patient's history and physical examination, necessary examinations are also made. In addition, medical imaging techniques such as ultrasound and x-rays can be used to examine the hernia more clearly. In case of suspected intestinal entrapment, some blood tests may also be requested to investigate infection and ischemia. After the completion and evaluation of all these examinations and diagnostic tests, the appropriate treatment plan for the patient can be determined by the physician and started as soon as possible.
How Is Umbilical Hernia Treated?
Umbilical hernia is one of the diseases that should be taken seriously from the first moment of its symptoms and immediately applied to health institutions. The most frequently recommended and safest treatment method for umbilical hernia is the patch technique. In hernia treatments using the patch method, the recurrence rate of hernia can be reduced to a very low rate of 1%. Pregnancy in women is a period in which umbilical hernias are common due to increased internal pressure in the abdomen. Umbilical hernias that arise directly inside or adjacent to the navel can be of any size between 1 centimeter and 6-7 centimeters. Medical Park General Surgery specialists Prof. Dr. Adem Dervişoğlu states that the possibility of recurrence is almost eliminated when the hernia is treated by using synthetic patches in both open and laparoscopic surgeries in hernia surgeries.
The effectiveness and success rate of treatment in cases of umbilical hernia are closely related to timely surgical intervention. In umbilical hernias, the only treatment option of which is surgical operation, most of the other treatment methods other than surgery fail, causing delays in the treatment, making the operation more difficult. Although laparoscopic surgery is preferred primarily if the size, location of the hernia and the patient's health condition are available, open surgery may also be required in some patients. Which of these two surgical methods should be preferred is decided by the physician by evaluating the clinical findings of the patient and the structure of the hernia. Generally, open surgery is preferred for hernias smaller than 3 centimeters. The reason for this is that 3 different entrance incisions should be opened in the laparoscopy technique; Since the hernia is small, the treatment can be performed with a single small incision with open surgery. However, laparoscopy is a more suitable option since the incision to be made with open surgery is much larger in large hernias. In surgical hernia operations performed with the open or closed patch method, the opening created by the hernia is closed without stretching, just like a patch, with the help of a special material such as gauze. The application of the patch technique by a specialist surgeon prevents the occurrence of negativities such as the presence of a foreign body and discomfort in the patients, enables the development of healthy tissue in the operation area, and ensures that it is resistant to tensions. The use of alcohol and cigarettes in patients whose treatment is completed after the operation prolongs the healing process of the wound and increases the risk of recurrence of the hernia. Therefore, care should be taken to avoid smoking and alcohol use.