Umbilical Hernia - Umbilical Hernia

Umbilical hernia

An umbilical hernia (umbilical hernia) is a weakness in the connective tissue of the umbilical ring through which the umbilical cord passed. Usually the scarring will scar right after birth. Sometimes this opening in the abdominal wall only closes slowly and a gap (hernial opening) remains.

An umbilical hernia occurs in around five to ten percent of all babies after birth, the cause is the not yet fully developed abdominal wall in the area of the navel. Children with a very low birth weight and premature babies are particularly affected more often. An umbilical hernia can also occur in adulthood.

navigation

• Continue reading
• more on the subject
• Advice, downloads & tools

• Symptoms & Diagnosis
• therapy
• When is an operation necessary?
• Whom can I ask?
• How are the costs going to be covered?

In adults, all factors that lead to increased pressure in the abdominal cavity are risk factors for an umbilical hernia - for example, being very overweight (obese), heavy lifting, etc. There is also an increased risk of an umbilical hernia during pregnancy. Another risk factor for an umbilical hernia can be a genetic predisposition to weak connective tissue.

Symptoms & Diagnosis

An umbilical hernia usually causes no or only mild symptoms. However, when abdominal viscera get caught, it can be extremely painful. An umbilical hernia is noticeable by a protrusion in the area of the umbilicus that can be pushed back into the abdominal cavity. This protrusion can usually be seen when screaming, coughing, straining (bowel movements) or doing physical activity. When the abdominal muscles relax, the umbilical hernia is usually not externally visible.

The doctor makes the diagnosis by palpating the hernial sac. To assess the size of the umbilical hernia, a connection to the abdominal cavity and the contents of the hernia (intestine, fat, etc.), an ultrasound examination can be carried out.

In contrast to an inguinal hernia, an umbilical hernia often becomes trapped (incarceration). Umbilical hernias are five times more likely to get trapped than hernias (inguinal hernia approx. Two percent and umbilical hernia approx. Ten percent lifetime risk of entrapment). If pain suddenly occurs (often in connection with vomiting and nausea) and the protrusion can no longer be pushed back, there is a risk that parts of the intestine are pinched. Since this is an emergency, an emergency call should be made immediately, because every minute counts in the case of bowel entrapment.

therapy

An umbilical hernia rarely needs surgery in infants. Umbilical hernias with a small hernial opening (diameter less than two centimeters) usually close by themselves up to the age of one and a half years, as the child's abdominal muscles become increasingly stronger. However, it is still possible to reduce or close the umbilical hernia up to the second - sometimes up to the fifth year of life. A "small" umbilical hernia (diameter less than two centimeters) that occurred during pregnancy often disappears on its own.

Note Since umbilical hernias are very seldom pinched in childhood, the development of a small hernial opening is awaited in the first three years of life. Conservative treatment with umbilical patches or umbilical bandages is not recommended these days, as they do not accelerate healing and often lead to skin irritation.

When is an operation necessary?

The operation is usually performed under general anesthesia. Different surgical techniques are available:

• Closed umbilical hernia surgery: Using laparoscopy (minimally invasive), access to the hernial port is made through small incisions on the side of the abdominal wall. The hernial port is sometimes closed with the help of special instruments. A plastic mesh is always inserted into the abdominal wall, which can, however, also cover an open remaining hernia gap on the inside, which ensures reliable hernia care.
• Open umbilical hernia surgery for a small umbilical hernia: With the help of a small abdominal incision, the hernial sac is exposed from the skin umbilicus and the contents of the hernial sac are pushed back into the abdominal cavity. The hernial port is closed by sewing the edges of the hernia directly using a special seam technique. The small scar that arises is usually barely visible after a few months.
• Open umbilical hernia surgery for a large umbilical hernia: In the case of large (> two centimeters hernia) or recurring breaks (recurrence), it is also necessary to sew in a stabilizing plastic mesh to prevent repeated umbilical hernias. This mesh can be implanted in different levels of the abdominal wall.

What should you watch out for after the umbilical operation?

The umbilical hernia operation is a routine procedure. Complications are very rare. How long the patient should not exert themselves physically after the operation must be discussed with the treating doctor.

As with any other surgical procedure, bruises (hematomas) or seromas (accumulations of fluid) can also form after an umbilical hernia operation. Wound infection is also possible.

Whom can I ask?

You can contact the following doctors regarding diagnosis and therapy:

• General Practitioner,
• Doctor for paediatrics and adolescent medicine,
• Specialist in pediatric surgery.

How are the costs going to be covered?

All necessary and appropriate therapies are covered by the health insurance carriers. Your doctor or the outpatient clinic will generally settle accounts directly with your health insurance provider. However, you may have to pay a deductible with certain health insurance providers (BVAEB, SVS, SVS, BVAEB).

However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.

When hospitalization is necessary

In the case of an inpatient stay in the hospital, the hospital costs are billed. The patient has to pay a daily contribution to the costs.

For more information, see What does a hospital stay cost?