The umbilicus ("belly button") is in the center of the lower abdomen. It is the site through which vessels which provide nutrients to the fetus from the mother during development penetrate the fetal abdominal wall.
Umbilical hernias are fairly common. They are obvious at birth and are caused by a small defect in the abdominal muscles which allows a portion of the peritoneum (lining of the abdominal cavity) to protrude, and push the umbilicus outward. This is more obvious when the infant cries and the increased pressure results in more visible bulging. The defect is not usually treated surgically. In most cases, by age 3 the umbilical hernia shrinks and closes without treatment.
The indications for umbilical hernia repair include:
incarcerated (strangulated) umbilical hernia
defects not spontaneously closed by 4 to 5 years of age
children under 2 with very large defects unacceptable to parents for cosmetic reasons
General anesthesia is used. A curved incision is made under the umbilicus.
The hernia sac is identified and dissected from the underlying tissues, and cut out. The underlying tissues are then closed with strong nonabsorbable sutures. Skin edges are held with paper tape (steri-strips). The surgical scar should be hidden in the umbilical depression.
Children can usually go home within one to two days of an umbilical hernia repair. Recurrence is rare.
Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.