An umbilical hernia occurs when a portion of the intestine, fat, or fluid pushes through a weak spot in the abdominal muscles near the belly button, creating a soft bulge around the navel. While often present from birth or developing in adulthood, it represents an opening in the abdominal wall.
Understanding Typical Umbilical Hernias
Many umbilical hernias, particularly in infants and young children, present as a soft, painless bulge around the navel. This protrusion often becomes more noticeable when the child cries, coughs, or strains, and may flatten or disappear when they are relaxed or lying down. These hernias are considered benign and often close on their own, usually by the age of four or five years.
For adults, an umbilical hernia may also be asymptomatic, appearing as a reducible lump that can be gently pushed back into the abdomen. They often develop due to increased pressure on the abdominal wall, from activities such as heavy lifting, chronic coughing, or pregnancy. While they may not cause discomfort, adult umbilical hernias rarely resolve spontaneously and often require medical evaluation for monitoring or repair.
Recognizing Urgent Symptoms
An umbilical hernia can become a medical emergency when the protruding tissue becomes trapped (incarceration) or its blood supply is cut off (strangulation). A primary indicator of an emergency is if the hernia bulge becomes firm, tender, or intensely painful to the touch. This pain may be constant and worsen over time, differing significantly from the mild or absent discomfort of a typical hernia.
Another urgent sign is the inability to gently push the hernia back into the abdomen, indicating it has become irreducible. Changes in the skin color over the hernia, such as redness, purplish discoloration, or a darker hue, can suggest compromised blood flow to the trapped tissue. These color changes require immediate attention.
Signs of a potential bowel obstruction, where the trapped intestine blocks the passage of food or waste, also signal an emergency. These symptoms include persistent vomiting, severe abdominal cramping, and an inability to pass gas or have a bowel movement. A fever alongside these symptoms indicates a complication, suggesting infection or tissue death.
Immediate Steps for an Emergency
If any urgent symptoms appear, seek immediate medical attention. Proceed directly to the nearest emergency room or contact emergency medical services. Swift action can impact the outcome, particularly if the hernia has become strangulated.
While awaiting medical assistance, refrain from attempting to push the hernia back into the abdomen, especially if it is painful or irreducible. Forceful manipulation can cause further damage to the trapped tissue or the surrounding abdominal wall. Avoid eating or drinking anything, as emergency surgery may be necessary, and an empty stomach is required for such procedures.
Medical Evaluation and Treatment Options
Upon arrival at a medical facility, a healthcare professional will conduct a physical examination to assess the hernia, noting its size, tenderness, and reducibility. Imaging studies such as an ultrasound or CT scan are performed to visualize the contents of the hernia and determine the extent of any complications. These diagnostic tools help confirm incarceration or strangulation and guide treatment decisions.
For non-emergency umbilical hernias, particularly in infants, a watchful waiting approach is adopted, as many resolve naturally. In cases where the hernia is causing symptoms or is large, surgical repair is recommended to prevent future complications. When an umbilical hernia presents as an emergency, immediate surgical intervention is required.
Emergency surgery aims to relieve any obstruction or strangulation by returning the trapped tissue to the abdominal cavity. The surgeon then repairs the weakened area in the abdominal wall, using stitches or a synthetic mesh to reinforce the defect. This surgical correction restores blood flow to the affected organs and prevents further tissue damage or systemic complications.