The umbilical hernia forms due to the passage of part of the abdominal contents outside its cavity. It is made possible by the presence of an orifice, due to the incomplete closure of the umbilical cord. In children under 2 years old, hernia presents little risk of complications. Treatment depends on its size and the risk of strangulation it presents. Find out what umbilical hernia in children is and what causes it.
1. Definition of umbilical hernia
An umbilical hernia is a round-shaped swelling located near the umbilicus (navel), informs the digestive surgery department of the Diaconesses Croix Saint-Simon hospital group. This mass forms under the skin due to the passage of part of the contents of the abdomen (portion of intestine, peritoneum, abdominal fat) through an orifice in the umbilical cord. In this respect, we distinguish the neck of the hernia, which represents the size of the orifice; and the hernia sac, which refers to its volume. In children, umbilical hernia is a relatively common phenomenon, and most often benign. We are talking about congenital umbilical hernia. It can be permanently visible; or only appear at times when the child exerts pressure on the abdomen, in other words when he pushes, walks or cries. In the vast majority of cases, the umbilical hernia is painless and resolves spontaneously before the child is 2 years old. It then requires no treatment, just simple monitoring, explains the MSD Manual.
2. Causes of umbilical hernia in children
The umbilicus (or navel) corresponds to the scar left by the insertion of the umbilical cord into the stomach. The umbilical cord was the line of communication that existed in utero between the placenta and the fetus. However, as the pediatric surgery department of the Val d’Ouest clinic in Lyon explains, the umbilicus forms a fibrous ring which gradually tightens and closes. As long as the closure is not complete, elements of the abdomen, and in particular a portion of the intestine, can pass through the orifice and form an umbilical hernia. It is the result of a congenital malformation, and in no way the consequence of a bad section of the umbilical cord at the birth of the child.
In principle, during the first two years of the child’s life, the umbilicus completely closes, and the umbilical hernia disappears without any treatment being necessary. In rare cases, when the hernia is large, or when closure of the umbilicus is not complete by age 2, manipulation may be necessary to attempt to reduce the hernia. In exceptional cases, with risk of strangulation of the hernia (blockage and risk of necrosis of its contents) and therefore risk of intestinal obstruction, surgical intervention is decided.
Sources
- Umbilical Hernia in Children, MSD Manual – Consumer Version, August 2021
- Umbilical hernia, Visceral surgery department of the Vaud university hospital, January 25, 2018
- Umbilical hernia, white line hernia, epigastric hernia, Digestive surgery department of the Diaconesses Croix Saint-Simon hospital group
- Umbilical hernia, Pediatric surgery department of the Val d’Ouest clinic in Lyon
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