Umbilical hernia

Symptoms and causes

What is it?

An umbilical hernia, or a navel hernia, is caused by the protrusion of the peritoneum through a weak spot in the abdominal wall at or near the navel. While the foetus is developing inside the mother's womb, the umbilical cord passes through the foetus' abdominal muscles. After the birth of the child, the umbilical cord is cut and the remaining stump of tissue eventually dies off. Although the navel wound heals, the navel remains a lifelong weak spot in the abdominal wall.

Today, many procedures in the abdomen (e.g. appendix, gallbladder, inguinal herniae) are performed with keyhole surgery . Sometimes an umbilical hernia develops at this site, even if the opening is stitched close after the keyhole surgery. Umbilical herniae are by definition small incisional herniae, but they are treated in the same way as spontaneous umbilical herniae.

Diagnosis and treatment

Does every umbilical hernia require treatment?

Absolutely not!

Many umbilical herniae cause little or no discomfort. Many people have a small umbilical herniae, but are unaware of this. Umbilical herniae can remain very small for life without causing any complaints. So, it is certainly not necessary to repair all umbilical hernias. On the other hand, some people have a painful and ever-growing umbilical hernia because they are afraid to undergo surgery. Consequently, certain people report having very large umbilical hernias.
An umbilical hernia that is very painful, swollenand cannot be pushed away is a matter of urgency. A so-called‘strangulated umbilical hernia’ may contain intestinal structures that can die off because the blood supply is interrupted. In this case, go to the A&E immediately. If the umbilical hernia cannot be pushed back there either, urgent surgery is required.
Nevertheless, a strangulated umbilical hernia is rather rare and more than 90% of patients undergo surgery in non-urgent conditions.