What an Umbilical Hernia Is and What to Do About It
Fetus and Umbilical Cord
First Reactions to an Umbilical Hernia
When a person is diagnosed with an umbilical hernia, embarrassment is one of the responses to the ugly and disfiguring bulge on their lower belly. What is this condition? What can be done about it? Is it serious? Is it potentially life-threatening? Let's find out more about the umbilical hernia?
Where does an Adult Umbilical Hernia Occur?
To understand this particular kind of a hernia, we need to discuss the human navel and the umbilical cord.
This twenty-inch (51 cm) tube begins with one branch that runs from the embryo's heart. A second branch originates in the liver. These join to form a single tube that passes through the fetus's abdominal wall made of muscle, out through what will later be called the navel and on to where it attaches to the mother's uterine wall.
The hole through which the umbilical cord passed has long since healed when the person becomes an adult. But the site of the umbilical cord's exit will always be the weakest spot of the abdominal cavity wall.
Thumbnails of Umbilical Hernias and a Normal Navel (Click to Enlarge)
What Is an Umbilical Hernia?
When an adult suffers an umbilical hernia, we are talking about a separation of the muscle of the abdominal wall at the precise location where the umbilical cord passed through on its way out of the baby's body via the navel/belly button location.
There are three biological structures within the abdominal cavity which excessive pressure could force through the hole.
- The Intestines—The portion of the gastrointestinal tract between the end of the stomach and the anus.
- The peritoneum—a highly enervated lining of the abdominal cavity which covers and supports the organs of the abdomen and provides a pathway for blood and lymph vessels.
- The omentum—a layer or apron of fat which runs down the front of the adult's abdomen.
A small part of one of these three structures may slip through the newly opened hole. Unless the hole in the muscle wall is mended, the structure will continue to work its way out. The results can be extremely uncomfortable and painful. This situation can also be life-threatening.
If the small intestine works its way through this hole, it could become snagged in such a way that blood flow is blocked. This condition is known as intestinal strangulation. The tissue itself may die and become gangrenous which is a life-threatening situation.
Abdominal Contents Slipping Through the Opening in the Abdominal Muscle (Red)
Any one of the following conditions could produce enough pressure to force a portion of the intestines, the peritoneum or the omentum through the newly opened hole in the abdominal wall producing an umbilical hernia:
- A pregnancy with twins, triplets or more.
- Excessive coughing
- Excessive straining due to constipation
- Lifting heavyweight
- Frequent pregnancies
- Abdominal surgery
- Ascites—accumulation of fluid in the abdominal cavity
- Uncharacteristic puffiness or a bulge of the navel area.
- Tenderness of the navel area.
- Possible discoloration of the navel area
Heavy Lifting Can Cause an Umbilical Hernia
Diagnosing an Adult Umbilical Hernia
The doctor will do some or all of the following:
- Your doctor will press on the swollen, bulging navel to see if the trapped tissue can be pushed back through the separation in the muscle of the abdomen. This is called reducing the hernia. Even if the doctor is successful at reducing the hernia, surgery is usually required to ensure it does not happen again.
- The doctor may also order an x-ray, ultrasound or CT scan if he is unsure about the diagnosis.
- Blood tests are usually ordered as well.
Repairing an Umbilical Hernia
Surgery is the primary treatment for an umbilical hernia. The surgeon will access the abdomen via the open or the laparoscopic method.
- Open surgery—The surgeon makes an incision that exposes the entire operative area. A polypropylene mesh is placed behind the muscular wall of the abdominal cavity to prevent the intestines, peritoneum, and omentum from slipping through the umbilical hole.
- Laparoscopic surgery-The surgeon makes small incisions through which he inserts a camera and surgical instruments to perform the procedure. A composite mesh is placed behind the muscular wall of the abdominal cavity to prevent the contents of the abdomen from slipping through.
The Best Outcome
When a person experiences an umbilical hernia, embarrassment due to the appearance may be one of the results. They may try to ignore the symptoms and hope it goes away. The best response is to visit your doctor and get reliable information. Following the directions of the surgeon, both before and after surgery, will provide the least chance of a recurrence and the best possible outcome.