An umbilical hernia in adults involves a portion of tissue bulging through a weak spot in the abdominal muscles near the belly button. This often appears as a noticeable lump or swelling. While many umbilical hernias are not immediately dangerous, some can develop complications requiring prompt medical attention.
What is an Umbilical Hernia?
An umbilical hernia forms when a defect or opening in the abdominal wall muscles around the navel allows internal contents, such as part of the small intestine or fatty tissue, to push outwards, creating a visible bulge. While common in infants and often self-resolving, adult umbilical hernias typically do not resolve spontaneously. Most adult umbilical hernias result from increased abdominal pressure, which weakens the abdominal wall. Contributing factors include obesity, multiple pregnancies, chronic coughing, or heavy lifting. Initially, the bulge may be soft and reducible, meaning it can be gently pushed back into the abdomen.
Warning Signs of Complications
Changes in an umbilical hernia can indicate complications requiring immediate medical evaluation. A sudden increase in pain or tenderness at the hernia site is a significant warning sign. The skin over the hernia may also show signs of distress, such as redness, darkening, or purple discoloration.
Other concerning symptoms include swelling or enlargement of the bulge that does not decrease with gentle pressure or when lying down. If the bulge becomes firm and cannot be pushed back into the abdomen, this is a serious indication. Digestive issues like nausea, vomiting, or an inability to pass gas or have a bowel movement suggest a potential obstruction. A fever accompanied by these symptoms can also signal an infection or severe internal distress.
Understanding Serious Risks
The warning signs of a complicated umbilical hernia point to two main serious conditions: incarceration and strangulation. Incarceration occurs when the herniated tissue becomes trapped outside the abdominal cavity and cannot be pushed back inside. This can lead to an intestinal blockage, causing symptoms like severe pain, a distended abdomen, and problems with bowel function. An incarcerated hernia, if untreated, can progress to a more severe state.
Strangulation is a medical emergency where the blood supply to the trapped tissue is cut off. This severe complication can lead to tissue death (necrosis or gangrene) within hours. Dead tissue can release toxins into the bloodstream, potentially causing widespread infection (sepsis) or bowel rupture. Immediate surgical intervention is required to restore blood flow and prevent life-threatening consequences such as peritonitis or bowel perforation.
Seeking Medical Evaluation
If any warning signs are present, seeking immediate medical attention is essential, typically at an emergency room or urgent care center. A healthcare provider usually diagnoses an umbilical hernia through a physical examination, assessing the bulge and associated symptoms. Imaging studies like an ultrasound or CT scan may be used to assess the hernia’s contents and check for complications.
For small, asymptomatic, and reducible umbilical hernias, watchful waiting might be recommended. However, this approach is only suitable under specific conditions and not if warning signs of complications are present. When complications like incarceration or strangulation occur, surgical repair is necessary and often performed as an emergency procedure. The goal of surgery is to return the protruding tissue to the abdomen and strengthen the weak area of the abdominal wall.