Umbilical Hernia (Pediatric)
What causes umbilical hernia?
Umbilical hernias are commonly found in infants and children. An umbilical hernia is a bulge of intraabdominal organs through an opening in at the base of the umbilicus (belly button). Every baby is born with this small opening, and with time, the opening usually will close on its own without any medical therapy. The size of umbilical hernias varies from child to child. Many umbilical hernias close on their own by 5 years of age.
How is umbilical hernia diagnosed?
Parents may notice a "bulge" of their child's umbilicus. It is common for this bulge to get larger and become harder when your child cries or strains. This is because the pressure in the abdomen is increased, forcing the contents of the hernia out. Upon relaxation, the contents of the hernia are easily returned back into the abdomen, allowing the hernia to become soft again.
Potential complications: Incarcerated hernia
Very few complications are associated with having an umbilical hernia. However, parents should be aware of the possibility of an incarcerated hernia. Incarceration occurs when the contents of the hernia "get stuck" and cannot be pushed back into the abdominal cavity. If this happens, the blood supply may be impaired (strangulation) to the organs in the hernia sac. This can be an emergency.
If you see these signs contact your doctor or take your child to the emergency room:
pain from the hernia
discoloration of the hernia
a hernia that cannot be pushed back into the abdominal cavity (when the child is relaxed)
a hernia that looks different than before.
How is umbilical hernia treated?
It is generally recommended to wait for an umbilical hernia to close on its own. This occurs as the child grows and the abdominal muscles strengthen, closing the hernia off naturally. This usually happens by the age of 5 years, if not sooner.
Techniques such as taping or strapping a coin on the umbilicus to close the hernia are not effective and are not recommended. Surgery is not advised unless the hernia does not go away by the age of 5, becomes strangulated, or the hernia is very large and is therefore unlikely to close on its own. If your child requires abdominal surgery for a different reason, then the surgeon may repair the umbilical hernia during that operation.
Surgical correction of umbilical hernias is performed under general anesthesia. The operation is
performed by a pediatric surgeon who has had special training in the management of surgically
correctable problems in children. The surgeon will make a small incision under the belly button and close the opening using stitches that will eventually dissolve on their own.
How long will my child stay in the hospital?
After the operation your child will return back to the recovery area, and you can be with him or her while he or she is waking up. Some children are upset and confused as the anesthesia starts wearing off. This is temporary and not unusual. Most children will go home on the same day as soon as they are awake and able to drink liquids after the operation. If your child has other health problems, the surgeon may keep him or her in the hospital overnight to monitor his or her breathing. After surgery, your child will only need Tylenol or ibuprofen for a couple days to treat any discomfort or pain.
What is expected after surgery?
Swelling at the incision site is common after surgery. The swelling will resolve after a couple of weeks.
Infection at the surgery site is uncommon, but if you notice redness, tenderness, or drainage at the site, please contact the pediatric surgery office for evaluation.
The possibility of the hernia returning is very small. However, if bulge recurs after surgery, please contact the pediatric surgery office for evaluation.