An umbilical hernia is a defect in the abdominal wall that is not always symptomatic and can occur at different ages for different reasons, with a higher incidence in women and overweight patients.

How do the different types of hernias differ, and what should be done if they arise? 

This article will explore this topic. 

The different types of umbilical hernia

One type of congenital hernia is the omphalocele. This develops due to a physiological and genetic defect in the gestation phase, which underlies the incomplete or malfunctioning closure of the abdominal wall. 

On the other hand, when a hernia appears after the fall of the umbilical cord, it is called a neonatal hernia. Possible causes include malnutrition of the mother, a delayed healed cord, or even an improperly treated wound. 

However, adults can also experience umbilical hernia if they have constitutional factors that make them predisposed to hernia, particularly if they have poor muscle tone, perform excessive physical exertion, are overweight or obese, or have had repeated pregnancies in a short period. One of the causes of umbilical hernia is increased intra-abdominal pressure, often associated with a thin abdominal wall that cannot counteract this force.  

Among those listed, the major risk factors are obesity and multiple pregnancies. In adults, an umbilical hernia is an eversion of the umbilicus right through the umbilical scar. The small hernia tends to contain omental fat, and as it increases in size, it will be occupied by bowel loops.

What are the symptoms of an umbilical hernia?

Small hernias are often asymptomatic but always cause localized, visible swelling when standing or at the level of the umbilical scar (more challenging to detect when supine).

When they occur, symptoms include local discomfort, pain, and perceived soreness. Hernias also increase in size after sneezing, after lifting weights, or as a result of other exertions. 

An outpatient examination can confirm the diagnosis if an umbilical hernia is suspected. Subsequently, if the hernia is non-small, an imaging test such as a CT scan of the abdominal wall without contrast can measure the size and plan the correct surgical approach.

Umbilical hernia: How does surgery work?

The primary treatment for the condition is indeed surgery.

For small hernias, a suture is applied to the abdominal tendon fascia under local anesthesia, and surgery is performed through a small surgical incision.

It is necessary to reconstruct and reinforce the abdominal wall using biocompatible material for medium and large hernias. This procedure can be performed either by a traditional anterior cut or laparoscopically with small incisions. The type of approach is decided based on the size of the hernia and the patient’s characteristics. In this case, the hospital stay is 1-3 days

This operation involves a short recovery, during which exertion should be avoided, and an elastic band should be worn. The patient will be able to return to work after 10/15 days and resume sports activity after 30 days once the doctor approves. 

In the case of neonatal hernia, a pediatric surgery specialist evaluation will be needed to decide the best timing for surgery. 

Also, in the case of a hernia caused by pregnancy, it is unnecessary to proceed with surgery if it resolves in the 10-12 months following delivery. 

Finally, suppose the hernia in the adult patient causes sharp, sudden pain. In that case, it cannot be reduced in the abdomen with finger pressure. The skin begins to redden, a stricture may be in progress, and urgent surgical intervention is necessary.