- An umbilical hernia is due to imperfect closure or weakness of the umbilical ring.
- Predisposing factors include black race and low birthweight.
- The hernia appears as a soft swelling covered by skin that protrudes during crying, coughing, or straining and can be reduced easily through the fibrous ring at the umbilicus.
- The hernia consists of omentum or portions of the small intestine. The size of the defect varies from < 1 cm in diameter to as much as 5 cm, but large defects are rare.
- Most umbilical hernias that appear before the age of 6 mo disappear spontaneously by 1 yr of age.
- Even large hernias (5-6 cm in all dimensions) have been known to disappear spontaneously by 5-6 yr of age.
- Strangulation (lack of return and loos of blood supply to hernia contents)is extremely rare.
- It is generally agreed that “strapping” is ineffective.
- Surgery is not advised unless the hernia persists to the age of 4-5 yr, causes symptoms, becomes strangulated, or becomes progressively larger after the age of 1-2 yr. Defects exceeding 2 cm are less likely to close spontaneously.
Dr. Jayaprakash
Superintendent, ICH.
Institute of Child Health.
Gov. Medical College Kottayam.
Kerala, India.