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Umbilical Hernia in Children

By William J. Cochran, MD, Associate, Department of Pediatrics GI and Nutrition;Clinical Professor, Department of Pediatrics, Geisinger Clinic, Danville, PA;Temple University School of Medicine

(For adults, see Abdominal Wall Hernias.)

A hernia is a small opening in the abdominal wall. An umbilical hernia occurs near or at the bellybutton (umbilicus).

  • Abdominal organs protrude through a hole in the in the abdominal wall near the bellybutton.

  • The diagnosis is based on the child's history and a physical examination.

  • Umbilical hernias typically close on their own.

In an umbilical hernia, the small intestine can protrude through the opening when the child coughs or strains during a bowel movement. Many infants have a small umbilical hernia because the opening for the umbilical cord blood vessels did not close completely.

Children usually do not have any symptoms. Rarely the intestine becomes trapped in the opening (incarcerated). Incarceration sometimes shuts off the blood supply to the intestine (strangulation), which is dangerous.

Diagnosis

  • A doctor's examination

Doctors base the diagnosis of umbilical hernia on the child's physical examination.

Treatment

  • Usually no treatment

  • For very large hernias, surgical repair

Because strangulation is very rare, umbilical hernias are usually not treated and doctors just wait for them to go away on their own. These hernias usually close by 5 years of age.

If a very large umbilical hernia does not close by the time a child is 2, the doctor may advise surgery. Folk remedies such as taping a coin or other object over the hernia do not work and may irritate the skin.

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