Umbilical hernias (alternative plural: herniae) are the most common ventral abdominal wall hernia and occur in the midline through the umbilicus.
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Epidemiology
Ten times more common in females 2 and represent ~5% of all abdominal hernias 4.
Clinical presentation
Umbilical hernias may present in the midline as a painless or painful mass.
Pathology
Umbilical hernias may be congenital or acquired 1,2:
- congenital: physiological herniation through the umbilicus occurs during the 10th week of gestation and congenital umbilical hernias occur when there is incomplete closure of the anterior abdominal wall after the gut returns to the abdominal cavity
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acquired: more common in adults
- risk factors: obesity, multiparity, ascites, large intra-abdominal mass
Umbilical hernias commonly contain fat, mesentery, small and/or large bowel.
Treatment and prognosis
There is a high rate of strangulation and incarceration of bowel and Richter hernias are common. Bowel obstruction is common and can be also be complicated by bowel ischemia.
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