An umbilical hernia, in the jargon called umbilical hernia, refers to a tear or opening in the abdominal wall through which the viscera can visibly emerge to the front. Affected are often infants, but also middle-aged women. Experts recommend that umbilical hernias in adults in principle operate.

What is an umbilical hernia?

Schematic representation of an umbilical hernia in infants. Click to enlarge.

Under an umbilical hernia doctors do not understand a break in the true sense. Rather, it is a crack or a hole in the abdominal wall, which lets the guts forward.

Often this happens by a violent pressing or a pressure through which the abdominal wall yields. The intestines are then kept only by the skin inside. Optically, an umbilical hernia is recognizable by a clearly visible bulge in the region of the navel, the so-called fracture sack.

Umbilical hernias are particularly common in infants. However, adults, especially women between the ages of 50 and 70, may also be affected.

causes

An umbilical hernia can arise for different reasons. Basically, a weakness of the abdominal wall in the area of ​​the former umbilical cord triggers the leakage of the intestines.

This weakness is genetic. It can either be innate or slowly educate in the course of life. Often, the abdominal wall does not grow properly after birth, which is the cause of common umbilical hernias in infants.

If an adult suffers from an umbilical hernia, the weakness of the abdominal wall has developed over the years. Then a strong load on the abdominal muscles or a violent pressing in pregnancy or constipation, to cause a tear in the abdominal wall.

Symptoms, complaints & signs

An umbilical hernia is first noticeable by a swelling or protrusion around the umbilicus. The swelling usually causes no complaints at the beginning. Depending on whether parts of the intestine are trapped, a pulling or burning may occur. Also characteristic are inflammatory signs such as hard or reddened spots.

The pain mainly occurs when bending, pressing, coughing or lifting heavy loads. Rarely, the intestine can settle in the fracture bag, resulting in severe pain. The affected intestinal region is also no longer adequately provided with blood and oxygen, which can lead to necrosis. Such a difficult course is also expressed by blood in the stool and other complaints during bowel movements.

In addition, colic, fever, and nausea and vomiting may occur in some cases. An entrapment of the intestine occurs in four of a hundred patients. In the remaining cases, the umbilical hernia is symptom-free and is only diagnosed during a routine examination. If the umbilical hernia is not treated, the symptoms increase.

Eventually, there can be a perforation that can lead to internal bleeding, infection and other life-threatening complications. With early diagnosis and treatment, the umbilical hernia symptoms completely disappear within a few weeks.

Diagnosis & History

Whether an umbilical hernia is present, the attending physician can determine primarily by performing an ultrasound examination.

In this way he can see if the bowels have changed their position. He can also try to push her back into the abdominal cavity with light pressure. If this is not possible or pain occurs, it may be that the intestines are pinched.

Then a quick operation becomes necessary. Basically, an umbilical hernia does not necessarily have to be treated because it does not pose any immediate danger to one's health without jamming the organs. Those affected must, however, realize that they do not heal by themselves - this only happens to infants up to three years old.

complications

During the first two years of life, an umbilical hernia usually heals by itself. At an older age, an umbilical hernia, especially if not treated promptly, can lead to serious and sometimes even life-threatening complications. Parts of the intestine can become trapped in the fractured sac, which is accompanied by very strong, colicky pain. The abdomen becomes very sensitive to pressure, even light touches during the examination can cause extreme pain in the patient.

Large umbilical hernias with parts of the large or small intestine in the hernia sac can cause diarrhea or constipation, and sometimes patients also see blood in their stools. In addition, there is a risk that the trapped intestine parts are no longer adequately supplied with blood and strive. Missing the protective abdominal wall, it can lead to dangerous injuries to the intestine, which often require emergency surgery.

Other possible complications include high fever combined with nausea and vomiting. In the case of entrapment, sweating, agonizing thirst, rapid heartbeat and severe hypotension occur frequently.

In case of late treatment, there is also the danger that the content of the fracture ignites or sticks to the environment, so that the fracture can no longer be reduced. If delayed surgery requires emergency surgery, the risk of pulmonary embolism increases.

When should you go to the doctor?

Irregularities and disorders in the umbilicus should be presented to a doctor. If it comes to swelling, discoloration of the skin or deformities, there is need for action. A visit to the doctor is necessary if there is a protrusion or knot formation at the navel. If the swelling increases in size, consult a doctor as soon as possible.

If pain occurs, the affected person needs help. Ingestion of analgesic drugs is to be omitted and should always be done only in consultation with a physician. There are risks and side effects, about which the person concerned must be informed and informed. Bleeding or loss of other body fluids from the navel are worrisome. They must be presented to a doctor so that a clarification of the cause can be made and a treatment plan is drawn up. If it comes to blood in the stool or in the urine, these complaints are to be discussed with a physician.

General malaise, nausea, indigestion, irregular heartbeat, or internal weakness are signs of ill health. If the symptoms persist or show increasing intensity, a doctor is needed. In case of fever, convulsions or colic a doctor should be consulted immediately. Since life-threatening developments can occur in an umbilical hernia, a check-up visit to a doctor should take place at the very first sign.

Treatment & Therapy

If the treating physician has clearly diagnosed an umbilical hernia, it must be considered whether and how this should be treated. In infants, treatment of the hernia usually does not occur, as it usually heals by itself until the age of about three years.

Under certain circumstances, the abdomen may be bandaged to aid this process. If an adult suffers from an umbilical hernia, there is no chance of self-healing. Experts suggest that the fracture should be surgically treated to minimize the risk of life-threatening organ deadlock.

Such surgery can even be performed on an outpatient basis; The patient can usually leave the clinic after a few hours.

Basically, there are two surgical methods to choose from, which differ in how big the umbilical hernia is in each individual case. For cracks up to about 2 cm, the abdominal wall is sutured with a firm seam. Here only a very small operation scar remains.

For larger cracks or holes, the abdominal wall is additionally reinforced with a plastic net, so that it can not lead to further or repeated umbilical hernias. If the procedure proceeds without complications, the patient can be active again after about 14 days without hesitation.

Outlook & Forecast

In infants, the prognosis of healing is very good. Umbilical hernias heal in infants 90 percent of all cases in the first year without complications. Sometimes parents need a little more patience, as complete closure of the abdominal wall can last up to 3 years of age. If the umbilical hernia is painless and an ultrasound does not show any abnormalities, the conditions in children are good for self-healing.

Adults, however, have to have an umbilical hernia operated sooner or later to avoid complications. The adult body no longer closes the holes and cracks independently. Self-healing is almost impossible. In an operation, the hole is covered with a plastic net and the healing accelerated. After such surgery, complications rarely occur. In some patients, there is a strong scarring. At the treated site there is an increased risk of breakage due to heavy stress (severe coughing, intense sports or heavy lifting). Physical activities are largely limited as long as the crack is not treated. The danger that the umbilical hernia grows larger and the operation more difficult is great.

prevention

Since an umbilical hernia is caused by a weakness of the abdominal wall, it can not be directly prevented. If there is a suspicion of umbilical hernia, a doctor should be consulted to rule out an organ blockage. Even if in most cases no treatment is necessary for young children, they should always be presented to the doctor if there is an umbilical hernia. This helps to avoid possible complications and to support healing.

aftercare

The purpose of the aftercare is, inter alia, to prevent the recurrence of new complaints. Therefore, physicians rely on a close follow-up. In umbilical hernia external circumstances lead to the disease. The patient can only try to get around them. Preventive measures include refraining from lifting heavy loads and reducing obesity.

A strengthening of the abdominal muscles also demonstrably prevents a renewed umbilical hernia. The implementation of these precautionary measures is the responsibility of the patient. If necessary, the doctor will inform you about appropriate preventive measures during the initial therapy. An umbilical hernia always heals completely.

In infants and expectant mothers even no treatment is required. With them, it comes after a short time usually to a spontaneous healing. Due to the absence of symptoms, there is no relevance to follow-up care at the end of therapy. Neither a long-term treatment nor an everyday accompaniment are necessary.

The patient is allowed to leave the hospital within a few days. In the case of an outpatient procedure, the recovery takes place at home. During a final examination, the doctor scans the affected area with his hands. An ultrasound examination may provide information that everything is healing according to expectations.

You can do that yourself

Since the umbilical hernia is often due to weakness of the connective tissue in the abdomen, the affected patient can do little about it. In children, umbilical hernias are relatively common and usually harmless. Since an umbilical hernia in children very often returns by itself, usually no therapeutic measures are taken. The bandaging of the body center can promote the healing process, but is rarely required. However, the fracture, which is recognizable as a protuberance under the skin, should be observed by the caregivers of the child. If the area changes, if the child is in pain or the skin turns bluish, a doctor must be consulted immediately.

Even during pregnancy, there are occasional umbilical hernias, which are also after birth but also very often by itself regress. Gymnastics and avoiding excessive weight gain can lower the risk of having an umbilical hernia in pregnant women.

Umbilical hernias in adults who do not expect a child are often due to incorrect physical work or heavy obesity. They are usually not dangerous, but should be treated surgically to prevent life-threatening organ deadlock, which is much more common in adults than in children. Anyone who suffers from an acute umbilical hernia should, above all, refrain from lifting hard, so as not to enlarge the break point. Even after a successful operation should be dispensed with heavy lifting, so it does not come to another umbilical hernia. If you are overweight, losing weight reduces the risk of umbilical hernia.

Tags: 
  • laboratory values 
  • active ingredients 
  • pregnancy 
  • teething 
  • education 
  • Top