An umbilical hernia is a protrusion of internal organs covered by peritoneum through the umbilical ring. There is practically no fat layer in this part of the abdominal wall, and the umbilical ring itself is covered from the inside only by connective tissue. It, unlike muscle tissue, can stretch, but not contract. Therefore, with a prolonged increase in intra-abdominal pressure, the umbilical ring becomes a “weak spot” through which internal organs, usually the intestinal wall, begin to protrude. In children, umbilical hernias account for up to 15% of all possible hernias, in adults - about 8%.
Umbilical hernia
An umbilical hernia is one of the most common pathologies of the body. Among known abdominal hernias, this disorder ranks third. The deviation is associated with dysfunction of the umbilical ring. This is the weakest and most vulnerable place on the anterior wall of the abdominal cavity.
There is no fat in the umbilical cavity area, it is not protected by muscle tissue, so this place is ideal for the localization and development of a hernia. The condition is characterized by protrusion of internal organs through the navel ring. Prolapsed organs end up in the hernial sac, which is a thin film of connective tissue.
At first, the hernial protrusion may be insignificant; a person just needs to lightly press on it and push it into place. It is not painful or dangerous, but such actions help temporarily. It is better not to get carried away with fixing the problem on your own and immediately begin more radical treatment with the participation of a doctor.
As the disease progresses to an advanced stage, the umbilical ring grows, which leads to an increase in the size of the hernia itself. It expands, bulges and causes discomfort.
Umbilical hernia in adults
Umbilical hernia in adults is an emotionally complex disease. Pathology is always noticeable and striking with its unattractiveness. It changes the natural contours and shapes of the abdomen.
You can hide under clothes, but in a bathhouse, on the beach or in a pool you can’t hide the defect. Pathological protrusions in adulthood are not only an aesthetic defect.
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Sakania Luiza Ruslanovna
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In adults, an umbilical hernia is much more complicated than in childhood.
The progression of the disease leads to severe complications. Let's try to figure out what the essence of the disease is and what the degree of its seriousness is.
Umbilical hernia in children
According to statistics, most cases of umbilical hernia occur in the neonatal and infancy periods of a child’s life, but adults also suffer from the disease.
An umbilical hernia in a newborn can develop due to:
- excess weight;
- slow healing process of the umbilical ring;
- severe cough;
- constant strong screaming (with colic);
- rickets (causes a decrease in muscle tone);
- constipation;
- increased intra-abdominal pressure;
- prematurity;
- severe pathologies (congenital);
- difficult pregnancy.
If the natural umbilical opening of a newborn closes up at the wrong time, a small hollow space is formed under the navel itself.
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Excessive straining, crying, and screaming of the baby provoke an increase in pressure inside the peritoneum and the subsequent release of part of the intestine into the cavity.
Externally, this is manifested by protrusion of the navel. Among adults, women are more often affected, especially those who have undergone childbirth, as a result of which the umbilical ring has expanded.
Men's bandages
A prerequisite for conservative treatment is wearing a bandage. If you are afraid of surgery or have contraindications to it, you should, first of all, choose a belt and wear it for the time specified by your doctor. At the same time, it is important to understand that even constantly wearing the product will not guarantee that the hernia will go away on its own. The goal of such treatment is to slow down the progression process and prevent strangulation of the sac.
There are a large number of bandages and each performs a specific role. Therefore, if it is recommended to treat the pathology with this particular method, you should first find out what kind of bandage you need. The following varieties can be found in the pharmacy chain:
- Preventive – the product is a very wide belt with a dense wall located on the stomach. It is used for prevention in men at high risk of developing pathology, that is, in the presence of weakness of the muscle wall or impaired blood circulation.
Mesh bandages can be used for preventive purposes
- Therapeutic – with their help, pathology is treated. As a rule, such products are more rigid, have ribs, and in the area of the hernia there is a seal that forces the tissues to return to the desired position. Such a bandage not only holds the protrusion, but also fixes the back, which has a positive effect on the muscle frame.
- Abdominal - these products are used after surgical treatment has been performed. Their responsibilities include maintaining the abdominal muscles, preventing suture dehiscence and accelerating the process of tissue repair.
The doctor determines which bandage is suitable. He will also tell you what size of products to take.
There is a separate type of bandages for the postoperative period
Doctors advise all men to wear bandages.
This will not solve the problem fundamentally. Wearing it will not resolve the hernia spontaneously.
But to prevent infringement while awaiting surgical intervention, this method has a right to exist.
You can find different types of bandages on sale. Structurally they are similar, the functions they perform differ.
Bandages will be:
- Preventative;
- Medicinal;
- Abdominal.
The preventive bandage is a wide belt with a reinforced front wall, which should be worn by men who are predisposed to developing the disease. It improves muscle tone and blood circulation.
The product performs 2 functions simultaneously: it supports the spine and helps improve muscle tone. The hernia is retained and its growth is reduced.
As for abdominal types of bandages, they need to be worn after surgery during the recovery stage. They protect postoperative sutures and prevent new hernias from appearing at the healing site.
Types of umbilical hernias
In children, umbilical hernias can be congenital or acquired.
Congenital hernias occur in the first month after birth. After birth, after the midwife cuts and ties the umbilical cord, the umbilical ring should contract. The abdominal muscles contribute to this contraction. But in some children, due to the incorrect location of collagen in the fibers of the connective tissue of the umbilical ring and in the surrounding muscles, the umbilical ring does not close or does not close completely, resulting in a hernial protrusion.
This most often happens in weakened, hypotrophic, and premature children. In this case, the closure of the umbilical ring takes much longer than in healthy children.
Acquired hernias appear in children of any age with increased pressure in the abdominal cavity, with constipation, flatulence, or with very strong screaming. If there is weakness in the umbilical ring, that is, a predisposition to a hernia, then sooner or later a hernial protrusion may appear.
Causes
The basis for the development of an umbilical hernia is the umbilical ring, which is one of the weakest points of the anterior abdominal wall, due to the lack of muscle cover and subcutaneous fat.
There is a theory of hereditary predisposition to the development of hernias, which is associated with underdevelopment of the umbilical fascia. However, as a rule, the occurrence of a hernia without any factors that increase intra-abdominal pressure or weaken the umbilical ring is impossible.
These factors are:
- delayed formation of the umbilical ring in young children;
- frequent annoying screaming and crying in infants;
- hereditary weakness of the connective tissue structure of the umbilical ring;
- postoperative scars;
- pregnancy;
- obesity;
- prolonged hacking cough (for example, with whooping cough, tuberculosis, etc.);
- excessive physical activity;
- ascites, hepatosplenomegaly;
- chronic constipation;
- injuries of the anterior abdominal wall;
- fast growing tumors.
Causes and mechanism of hernia
Umbilical hernias in adulthood are formed due to the expansion of the abdominal walls. Most often observed in girls after childbirth. Such deviations are observed for the following reasons:
- Weak connective tissue around the umbilical ring due to hereditary factors.
- Injury to the neuromuscular system.
- Conceiving a child after 35 years.
- Difficult pregnancy.
- Multiple pregnancy in a pregnant woman.
- High water.
- Congenital defect in the structure of the abdominal cavity.
- Sharp loss of body weight in the shortest possible time.
- Decreased muscle tone due to lack of physical activity.
Umbilical hernia is rare in pregnant women. For the disease to begin to develop, the body must be exposed to the following factors:
- Increased physical activity.
- Problems with the gastrointestinal tract.
- Development of benign prostatic hyperplasia.
- Chronic pathologies of the respiratory tract, characterized by a prolonged dry cough.
In adults, strangulated umbilical annular hernia is diagnosed extremely rarely. If the diagnosis is confirmed, then quick and high-quality treatment is required, otherwise the disease will progress and complications will begin.
Symptoms
The severity of symptoms of an umbilical hernia depends on many factors:
- its size;
- the presence of adhesions in the abdominal cavity;
- the presence or absence of strangulation of the hernial sac;
- general condition of the patient.
At the beginning of the development of an umbilical hernia, the patient notices a small protrusion in the navel area. Some pregnant women even mistake it for a normal pregnancy process and do not attach any significance to its occurrence.
The protrusion is easily reduced, disappears in the supine position, and the patient does not experience any discomfort due to its appearance. In some cases, a protruding omentum can completely block the umbilical ring, and such hernias do not change in size and subsequently proceed without any special symptoms.
If the omentum begins to pass through the expanded muscles, then the hernia increases in size and makes itself felt with more severe manifestations. As the disease progresses, adhesions form in the abdominal cavity, which interfere with the reduction of the hernial sac.
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Movement, physical activity, attempts to push - all this leads to pain and disturbances in the functioning of the intestines. The patient begins to complain of periodic constipation and nausea.
Progressive umbilical hernias are especially difficult to tolerate during obesity and pregnancy, since the growing belly constantly puts pressure on the muscles of the abdominal wall and aggravates the patient’s condition.
Clinical picture
Usually, as the disease develops, a swelling is clearly visible on the front of the abdominal wall in the area of the umbilical ring. Symptoms of the pathology are more noticeable if a person stands or strains his stomach.
When taking a lying position, the hernia may disappear, but this happens only at the initial stage of the disease. Other signs:
- Enlargement of the umbilical ring.
- Pain in the navel area accompanied by coughing and sneezing.
- Increased pain with physical activity.
- Development of constipation up to intestinal obstruction.
- Nausea, vomiting.
Typically, symptoms and sensations do not appear immediately, and their severity directly correlates with the stage of the disease. At the beginning of the disease, a person can repair a hernia on his own, and such pathology does not become an obstacle to normal life and work.
It is the absence of symptoms that leads to late treatment, when pain and discomfort become difficult to bear, and the walls of the hernia have fused with the skin and subcutaneous tissue. Also, over time, stretching of the hernial ring causes growth in size, which can lead to unpleasant complications.
Danger and consequences of umbilical hernia
The patient's condition usually worsens as the size of the hernia increases:
- The protrusion becomes dense, and when touching it the person experiences pain.
- The organs located in the hernia can no longer be put back into place.
- Inflammation of an organ located in the hernial sac. This is accompanied by swelling, pain, and redness in the navel area.
- The temperature rises and the general condition of the patient worsens. All these dangerous symptoms characterize the strangulated state of the umbilical hernia, the most severe form of the disease.
- Severe pain, vomiting, nausea and constipation occur.
- Blood stops flowing to the pinched, compressed organ, which leads to its death. This condition is life-threatening.
Without medical intervention, peritonitis may develop. Severe inflammation of the abdominal cavity can result in death. A complication with similar symptoms is intestinal obstruction. The part of the intestine caught in the hernia becomes clogged with feces.
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Without treatment, the prognosis is unfavorable; this complication can also significantly shorten human life. Any suspicious lump or protrusion in the navel area should be alarming.
Sometimes these signs characterize the presence of gastric cancer metastases. This is a rare occurrence, but for the sake of maintaining health and life, it is better to exclude any risk factors.
Complications
The most common consequence of an umbilical hernia is strangulation of an organ in the hernial sac. This happens abruptly during muscle contraction that pinches the organ and does not relax. At this time, blood circulation is disrupted and the organ gradually dies. Necrosis is life-threatening for the patient and during an emergency operation, part of the dead organ is removed, which can cause disability.
It is easy to avoid complications if you consult a doctor immediately after the appearance of swelling in the abdominal area and follow the prescribed prevention.
An umbilical hernia can be complicated by intestinal obstruction, inflammation of the contents of the hernial sac, rupture of the hernia, strangulation of the contents of the hernial sac, which, in turn, can cause the development of gangrene and death.
With timely diagnosis and adequate treatment, the prognosis is favorable. In the absence of necessary treatment, the prognosis worsens and the risk of developing complications of an umbilical hernia increases.
Diagnosis of umbilical hernia
Umbilical hernia in adults is one of the diseases the diagnosis of which does not cause problems.
The pathology is always visually noticeable; a person can see and feel it independently. If a deviation is detected, at a minimum, consultation with a doctor is required. It is better not to postpone a visit to a specialist; the duration and effectiveness of treatment will depend on this.
Diagnosis of the disease begins with an examination. The doctor feels the patient's abdomen and assesses the condition of the umbilical zone. The patient may be asked to strain and cough.
A conversation and clarification of the nature of the symptoms are mandatory. The doctor may ask when the protrusion was discovered, how it manifests itself, and whether there are close relatives who have had a similar pathology. After studying the information received, the doctor makes a preliminary diagnosis.
Additional research may be needed to confirm this:
- Ultrasound allows you to identify a hernial formation, determine its condition, contours and size. The study helps to see the organs that are in the hernial sac, the absence or presence of adhesions.
- Herniography is prescribed when there is doubt about the diagnosis. A radiopaque contrast agent is injected into the patient's abdomen. Once in the hernial sac, it stains it. As a result, all deviations are clearly visible on x-rays.
- X-ray with contrast, gastroduodenoscopy of the stomach and duodenum. Thanks to these diagnostic methods, the doctor has the opportunity to detect inflammatory and tumor processes that accompany an umbilical hernia and cause pain.
Diagnostics
To diagnose the development of an umbilical hernia, a man needs to see a surgeon. During the initial examination, examination and palpation of the umbilical ring area with the patient lying and sitting, the doctor may suspect the presence of an umbilical hernia. With a strangulated hernia, a sharply painful, unreducible protrusion is observed.
To confirm the diagnosis, a number of instrumental studies are used:
- ultrasound examination of the abdominal organs and peri-umbilical region, which reveals the discrepancy of the muscles of the anterior abdominal line and reveals areas of internal organs in the hernial sac;
- herniography (radiographic examination with contrast, allowing you to see the size and contents of the hernial sac).
If an umbilical hernia is the result of a pathology leading to an increase in intra-abdominal pressure, the attending surgeon, if necessary, refers you for a consultation with a gastroenterologist, therapist, or oncologist.
Treatment of umbilical hernia in children and adults
If the presence of pathology does not in any way affect the development of the child, treatment of umbilical hernia without surgery is practiced.
At the same time, it is important to control what the child eats, how often he goes to the toilet, and whether he is active during the day. It is necessary to try to prevent constipation and attacks of prolonged debilitating coughing and crying; conservative therapy (physical therapy, massage) is indicated. This tactic is followed for umbilical hernia in children under 5 years of age, but in most cases the formation disappears within 36 months.
Surgical intervention is used in the following cases:
- pathologies after 5-6 years;
- strangulated hernia;
- increasing the size of the protrusion.
The cost of umbilical hernia surgery is quite reasonable. More complete information can be obtained on our website: Dobrobut.com. This treatment is called hernioplasty. Its duration is no more than 30 minutes.
Surgery in adults with an umbilical hernia can be performed according to several schemes:
- traditional plastic surgery of the patient’s tissues, when it is often necessary to remove the navel itself or the fatty apron (if overweight);
- plastic with mesh implants.
The price of umbilical hernia removal depends on the patient’s age and the chosen surgical tactics. The question of the method of treatment is solely within the competence of the doctor.
In young children, umbilical hernia treatment is performed without surgery, including:
- frequently placing the baby on his stomach (helps reduce intra-abdominal pressure and strengthen the abdominal muscles);
- tummy massage.
Treatment of umbilical hernia in pregnant women
This pathology is often observed in pregnant women, but in the vast majority of cases it does not require immediate surgical treatment, since stress and medications used during the intervention can negatively affect the health of the unborn baby.
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Sakania Luiza Ruslanovna
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Women are recommended to wear a special bandage, which is selected individually and helps eliminate excessive tension in the abdominal wall. The doctor may also advise the patient to use compression or support garments.
A pregnant woman with an umbilical hernia is constantly monitored by a surgeon, who will help you choose the optimal time for surgery after childbirth. In the process of such intervention, other defects of the abdominal wall caused by pregnancy (stretching and sagging of the skin, removal of excess fatty tissue) can also be eliminated.
It is optimal to carry out such operations 6–8 months after delivery, since it is during this time that the stretched muscles of the abdominal wall and the mother’s body are restored.
Treatment of paraumbilical hernia
Periumbilical hernia, like any other linea alba, does not respond well to conservative treatment. Therefore, like any other hernia, it can be treated exclusively with surgical intervention.
The urgency of the operation and the nature of the treatment depend on its size, pain, and the risk of strangulation. It is important to remember that over time it can grow and the hernial ring can stretch. This may complicate the operation.
A hernia near the navel is most often removed using hernioplasty.
