A hernia protruding from the umbilicus is called an umbilical hernia. Clinically, it is divided into two types: infant umbilical hernia and adult umbilical hernia.

bubble_chart Etiology

Due to developmental defects in the umbilicus, the umbilical ring fails to close, or after the umbilical cord falls off, the tissue at the base of the cord adheres to the umbilical ring and heals poorly. Under conditions of increased intra-abdominal pressure, the omentum or intestines protrude through the weak area of the umbilicus, forming an umbilical hernia.

bubble_chart Clinical Manifestations

A reducible mass at the umbilicus is the most important clinical manifestation, especially more noticeable when the infant cries, and there are usually no other symptoms. Since the abdominal wall and the hernia ring in infants are relatively soft, incarceration is extremely rare.

bubble_chart Treatment Measures

Small umbilical hernias, such as those with a diameter less than 1.5cm, often heal spontaneously by the age of 2 as the abdominal wall strengthens with development. Given that incarceration is rare in infant umbilical hernias, non-surgical treatment can be initially adopted, such as adhesive tape application therapy. This involves using wide strips of adhesive tape to pull and fix the abdominal wall toward the midline, preventing hernia protrusion and keeping the umbilicus tension-free, thereby allowing the umbilical orifice to gradually heal and close. The tape should be changed weekly. If adhesive tape dermatitis occurs, an abdominal binder with appropriate pressure can be used instead.

If the child is over 2 years old and the umbilical hernia has not healed spontaneously, surgical treatment is recommended. The specific surgical procedure involves making a corresponding curved incision 1–2cm below the umbilical hernia, freeing the skin flap, and exposing the anterior sheaths of the rectus abdominis muscles on both sides. The linea alba and hernia sac are incised; if there is no intact hernia sac, the abdominal membrane is incised. The intestines are repositioned, the hernia sac is excised, and the edges of the incised abdominal membrane are sutured at the hernia ring. The transverse abdominal membrane is sutured horizontally, followed by vertical suturing of the linea alba to close the umbilical ring and reinforce the weakened area of the abdominal wall. Finally, the preserved umbilical skin flap is sutured back into its original position.