Materiały źródłowe

• #1 Umbilical Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459312/

  An umbilical hernia is a defect in the ventral abdominal fascia at or near the umbilicus. […] Approximately 90% of adult umbilical hernias are acquired. […] Stretching of the abdominal musculature and excess adiposity separate muscles and weaken aponeuroses, facilitating the occurrence of umbilical hernias. […] Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #2 Umbilical Hernia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30753

  Approximately 90% of adult umbilical hernias are acquired. […] Umbilical hernias are more common in persons with obesity, metabolic syndrome, ascites, and in those with a history of multiple pregnancies. […] Certain configurations of the umbilical ring can also influence the formation of an umbilical hernia. […] Any chronic or repetitive increase in intraabdominal pressure may increase the risk for an umbilical hernia, and there may be an association between the use of umbilical site laparoscopic trocars and umbilical hernias. […] Additional predisposing factors for adult umbilical hernias include connective tissue disorders, ethnic background, Beckwith-Wiedemann syndrome, Trisomy 21, and poor nutrition. […] Stretching of the abdominal musculature and excess adiposity separate muscles and weaken aponeuroses, facilitating the occurrence of umbilical hernias.

• #3 Umbilical Hernia: Symptoms, What It Is, Treatment & Surgery

  https://my.clevelandclinic.org/health/diseases/umbilical-hernia

  An umbilical hernia is an unusual bulge you can often see or feel over your belly button (umbilicus). It develops when part of your small intestine, together with fat or fluid, forms a sac. The sac pushes through an opening or weakness in your abdominal wall muscle. […] In adults, umbilical hernias happen when pressure in your abdomen causes weaknesses in your abdominal wall muscles. Parts of your small intestine and related tissue can bulge through the weakened muscle. […] During the procedure to treat umbilical hernia, a surgeon makes incisions (cuts) that allow them to access the hernia and push the tissue back into place. Then, they strengthen the abdominal wall muscle to hold the tissue in place. Sometimes, they use a material called surgical mesh to strengthen the tissue barrier.

• #4 Pediatric Umbilical Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459294/

  Umbilical hernias occur due to the incomplete closure of the umbilical ring fascia, allowing intraabdominal contents to protrude through it. […] Following the separation of the umbilical cord, the fascial ring usually undergoes natural closure due to the growth of the rectus muscles and fusion of the fascial layers. However, if this process is hindered or delayed, it can result in the development of an umbilical hernia. […] If the umbilical ring fails to close and obliterate after the separation of the umbilical cord, it will increase the risk of developing an umbilical hernia. […] The umbilicus also serves as a relatively vulnerable area in the abdominal wall and is susceptible to herniation due to chronic elevation of intra-abdominal pressure. […] During fetal development, the primitive umbilical ring emerges as early as the fourth week of gestation on the ventral surface of the body. The umbilical ring comprises the umbilical blood vessels (containing 1 vein and 2 arteries), the allantois, the vitelline duct, vitelline vessels, and a loop of the midgut.

• #5 Umbilical hernia pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Umbilical_hernia_pathophysiology

  The pathophysiology of umbilical hernia involves the weakness of abdominal fascia or failure to fully form the fascia which may lead to an umbilical hernia in the newborn. During the fifth to tenth weeks of gestation, the intestinal tract undergoes rapid growth with protrusion of the abdominal content outside the abdominal cavity. This is followed by a gradual re-entry of the abdominal cavity and then the narrowing of the umbilical ring which completes the process of abdominal wall formation. […] The pathophysiology of umbilical hernia is as follows: During fetal development, the abdominal wall is formed by four separate embryologic folds: Cephalic, Caudal, Right and left lateral. Each fold is composed of somatic and splanchnic layers. The folds develop towards the anterior center portion of the coelomic cavity (derived from mesoderm in humans) and ultimately join to form a large umbilical ring that surrounds the following structures: Two umbilical arteries, Umbilical vein, Yolk sac (omphalomesenteric duct). These structures are enclosed by the outer layer of amnion.

• #6 Umbilical hernia pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Umbilical_hernia_pathophysiology

  During the time between fifth and tenth weeks of gestation, the intestinal tract undergoes rapid growth with protrusion of the abdominal content outside the abdominal cavity. This is followed by a gradual re-entry of the abdominal cavity and then the ultimate narrowing of the umbilical ring which completes the process of abdominal wall formation as fetal development concludes. Weak fascia or failure to fully form the fascia may predispose the newborn to an umbilical hernia.

• #7 Pediatric Umbilical Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459294/

  After birth, the umbilical vessels undergo obliteration and are subsequently replaced by a ligamentous structure. […] Congenital disorders of the umbilicus encompass umbilical hernia, patent urachus, omphalomesenteric fistula, and umbilical polyp. Identifying these abnormalities as early as possible is crucial to minimize potential complications.

• #8

  https://www.nhs.uk/conditions/umbilical-hernia-repair/

  During pregnancy, the umbilical cord passes through an opening in the baby’s abdomen (tummy). This opening should close shortly after birth, but in some cases the muscles don’t seal completely. […] This leaves a weak spot in the surrounding muscle wall (abdominal wall). An umbilical hernia can develop when fatty tissue or a part of the bowel pokes through into an area near the navel. […] In adults, factors that can contribute to developing an umbilical hernia include: being overweight or obese, straining while you are lifting or moving heavy objects, having a persistent heavy cough, having a multiple pregnancy such as twins or triplets.

• #9 Umbilical hernia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/umbilical-hernia/symptoms-causes/syc-20378685

  An umbilical hernia occurs when part of your intestine bulges through the opening in your abdominal muscles near your bellybutton (navel). […] An umbilical hernia creates a soft swelling or bulge near the navel. It occurs when part of the intestine protrudes through the umbilical opening in the abdominal muscles. […] During gestation, the umbilical cord passes through a small opening in the baby’s abdominal muscles. The opening normally closes just after birth. If the muscles don’t join together completely in the midline of the abdominal wall, an umbilical hernia may appear at birth or later in life. […] In adults, too much abdominal pressure contributes to umbilical hernias. Causes of increased pressure in the abdomen include: Obesity, Multiple pregnancies, Fluid in the abdominal cavity, Previous abdominal surgery, Long-term peritoneal dialysis to treat kidney failure.

• #10 Umbilical Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459312/

  An umbilical hernia is a defect in the ventral abdominal fascia at or near the umbilicus. […] Approximately 90% of adult umbilical hernias are acquired. […] Stretching of the abdominal musculature and excess adiposity separate muscles and weaken aponeuroses, facilitating the occurrence of umbilical hernias. […] Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #11 Umbilical Hernia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30753

  Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Patients with umbilical hernias often lack an umbilical fascia, and the round hepatic ligament may be abnormally attached to the inferior margin of the umbilical ring. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #12 Pediatric Umbilical Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459294/

  Umbilical hernias occur due to the incomplete closure of the umbilical ring fascia, allowing intraabdominal contents to protrude through it. […] Following the separation of the umbilical cord, the fascial ring usually undergoes natural closure due to the growth of the rectus muscles and fusion of the fascial layers. However, if this process is hindered or delayed, it can result in the development of an umbilical hernia. […] If the umbilical ring fails to close and obliterate after the separation of the umbilical cord, it will increase the risk of developing an umbilical hernia. […] The umbilicus also serves as a relatively vulnerable area in the abdominal wall and is susceptible to herniation due to chronic elevation of intra-abdominal pressure. […] During fetal development, the primitive umbilical ring emerges as early as the fourth week of gestation on the ventral surface of the body. The umbilical ring comprises the umbilical blood vessels (containing 1 vein and 2 arteries), the allantois, the vitelline duct, vitelline vessels, and a loop of the midgut.

• #13 Umbilical Hernia: Symptoms, What It Is, Treatment & Surgery

  https://my.clevelandclinic.org/health/diseases/umbilical-hernia

  An umbilical hernia is an unusual bulge you can often see or feel over your belly button (umbilicus). It develops when part of your small intestine, together with fat or fluid, forms a sac. The sac pushes through an opening or weakness in your abdominal wall muscle. […] In adults, umbilical hernias happen when pressure in your abdomen causes weaknesses in your abdominal wall muscles. Parts of your small intestine and related tissue can bulge through the weakened muscle. […] During the procedure to treat umbilical hernia, a surgeon makes incisions (cuts) that allow them to access the hernia and push the tissue back into place. Then, they strengthen the abdominal wall muscle to hold the tissue in place. Sometimes, they use a material called surgical mesh to strengthen the tissue barrier.

• #14 Umbilical hernia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/umbilical-hernia/symptoms-causes/syc-20378685

  An umbilical hernia occurs when part of your intestine bulges through the opening in your abdominal muscles near your bellybutton (navel). […] An umbilical hernia creates a soft swelling or bulge near the navel. It occurs when part of the intestine protrudes through the umbilical opening in the abdominal muscles. […] During gestation, the umbilical cord passes through a small opening in the baby’s abdominal muscles. The opening normally closes just after birth. If the muscles don’t join together completely in the midline of the abdominal wall, an umbilical hernia may appear at birth or later in life. […] In adults, too much abdominal pressure contributes to umbilical hernias. Causes of increased pressure in the abdomen include: Obesity, Multiple pregnancies, Fluid in the abdominal cavity, Previous abdominal surgery, Long-term peritoneal dialysis to treat kidney failure.

• #15 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Umbilical hernias account for 10% of abdominal-wall hernias. Conditions that lead to increased intra-abdominal pressure and weakened fascia at the level of the umbilicus (eg, obesity, ascites, multiple pregnancies, and large abdominal tumors) contribute to the development of umbilical hernias. […] The most common symptom of umbilical hernias is pain at the umbilicus (44% of cases). Other complaints include pressure (20%) and nausea and vomiting (9%). Complications such as irreducibility, obstruction, strangulation, skin ulceration, and rupture are more common in paraumbilical hernias than in other abdominal hernias. […] All adult umbilical hernias should be repaired, owing to the high risk of complications. Indications for operative repair include the following: Pain, Incarceration, Strangulation, Defect larger than 1 cm, Skin ulceration, Hernia rupture.

• #16 Umbilical hernia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/umbilical-hernia/symptoms-causes/syc-20378685

  An umbilical hernia occurs when part of your intestine bulges through the opening in your abdominal muscles near your bellybutton (navel). […] An umbilical hernia creates a soft swelling or bulge near the navel. It occurs when part of the intestine protrudes through the umbilical opening in the abdominal muscles. […] During gestation, the umbilical cord passes through a small opening in the baby’s abdominal muscles. The opening normally closes just after birth. If the muscles don’t join together completely in the midline of the abdominal wall, an umbilical hernia may appear at birth or later in life. […] In adults, too much abdominal pressure contributes to umbilical hernias. Causes of increased pressure in the abdomen include: Obesity, Multiple pregnancies, Fluid in the abdominal cavity, Previous abdominal surgery, Long-term peritoneal dialysis to treat kidney failure.

• #17

  https://www.nhs.uk/conditions/umbilical-hernia-repair/

  During pregnancy, the umbilical cord passes through an opening in the baby’s abdomen (tummy). This opening should close shortly after birth, but in some cases the muscles don’t seal completely. […] This leaves a weak spot in the surrounding muscle wall (abdominal wall). An umbilical hernia can develop when fatty tissue or a part of the bowel pokes through into an area near the navel. […] In adults, factors that can contribute to developing an umbilical hernia include: being overweight or obese, straining while you are lifting or moving heavy objects, having a persistent heavy cough, having a multiple pregnancy such as twins or triplets.

• #18 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Umbilical hernias account for 10% of abdominal-wall hernias. Conditions that lead to increased intra-abdominal pressure and weakened fascia at the level of the umbilicus (eg, obesity, ascites, multiple pregnancies, and large abdominal tumors) contribute to the development of umbilical hernias. […] The most common symptom of umbilical hernias is pain at the umbilicus (44% of cases). Other complaints include pressure (20%) and nausea and vomiting (9%). Complications such as irreducibility, obstruction, strangulation, skin ulceration, and rupture are more common in paraumbilical hernias than in other abdominal hernias. […] All adult umbilical hernias should be repaired, owing to the high risk of complications. Indications for operative repair include the following: Pain, Incarceration, Strangulation, Defect larger than 1 cm, Skin ulceration, Hernia rupture.

• #19 Umbilical hernia: when and how – Maia – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5123/html

  The incidence of umbilical hernias in adults ranges from 10% to 25% in the literature and is increased in females. Some predisposing factors for umbilical hernia development include pregnancy, obesity, ascites and large abdominal tumors leading to increased abdominal pressure. […] A true umbilical hernia is congenital and results from a failure of closure of the umbilical ring in the early years of life. In adults, umbilical hernias are usually acquired, defined as a defect from 3 cm above to 3 cm below the umbilicus and they are usually classified as indirect hernia. […] Some predisposing factors for the development of umbilical hernia include pregnancy, obesity, ascites and large abdominal tumor leading to increased abdominal pressure. […] Umbilical hernia repair in a cirrhotic patient with ascites is a very challenging scenario. In the past, most surgeons would avoid repairing any umbilical hernia in patients with more than Child-Pugh A liver cirrhosis unless in emergency situations. The incidence of umbilical hernias in cirrhotic patients is approximately 20%, higher than in the general population and occurs more on males than in females. These hernias tend to enlarge rapidly and have a marked predisposition for complications.

• #20 Umbilical Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459312/

  An umbilical hernia is a defect in the ventral abdominal fascia at or near the umbilicus. […] Approximately 90% of adult umbilical hernias are acquired. […] Stretching of the abdominal musculature and excess adiposity separate muscles and weaken aponeuroses, facilitating the occurrence of umbilical hernias. […] Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #21 Umbilical hernia – Wikipedia

  https://en.wikipedia.org/wiki/Umbilical_hernia

  An umbilical hernia is a health condition where the abdominal wall behind the navel is damaged. It may cause the navel to bulge outwardsthe bulge consisting of abdominal fat from the greater omentum or occasionally parts of the small intestine. The bulge can often be pressed back through the hole in the abdominal wall, and may „pop out” when coughing or otherwise acting to increase intra-abdominal pressure. Treatment is surgical, and surgery may be performed for cosmetic as well as health-related reasons. […] The causes of umbilical hernia are congenital and acquired malformation, but an apparent third cause is really a cause of a different type, a paraumbilical hernia. […] An acquired umbilical hernia directly results from increased intra-abdominal pressure caused by obesity, heavy lifting, a long history of coughing, or multiple pregnancies.

• #22

  https://www.nhs.uk/conditions/umbilical-hernia-repair/

  During pregnancy, the umbilical cord passes through an opening in the baby’s abdomen (tummy). This opening should close shortly after birth, but in some cases the muscles don’t seal completely. […] This leaves a weak spot in the surrounding muscle wall (abdominal wall). An umbilical hernia can develop when fatty tissue or a part of the bowel pokes through into an area near the navel. […] In adults, factors that can contribute to developing an umbilical hernia include: being overweight or obese, straining while you are lifting or moving heavy objects, having a persistent heavy cough, having a multiple pregnancy such as twins or triplets.

• #23 Umbilical Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459312/

  An umbilical hernia is a defect in the ventral abdominal fascia at or near the umbilicus. […] Approximately 90% of adult umbilical hernias are acquired. […] Stretching of the abdominal musculature and excess adiposity separate muscles and weaken aponeuroses, facilitating the occurrence of umbilical hernias. […] Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #24 Umbilical hernia: when and how – Maia – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5123/html

  The incidence of umbilical hernias in adults ranges from 10% to 25% in the literature and is increased in females. Some predisposing factors for umbilical hernia development include pregnancy, obesity, ascites and large abdominal tumors leading to increased abdominal pressure. […] A true umbilical hernia is congenital and results from a failure of closure of the umbilical ring in the early years of life. In adults, umbilical hernias are usually acquired, defined as a defect from 3 cm above to 3 cm below the umbilicus and they are usually classified as indirect hernia. […] Some predisposing factors for the development of umbilical hernia include pregnancy, obesity, ascites and large abdominal tumor leading to increased abdominal pressure. […] Umbilical hernia repair in a cirrhotic patient with ascites is a very challenging scenario. In the past, most surgeons would avoid repairing any umbilical hernia in patients with more than Child-Pugh A liver cirrhosis unless in emergency situations. The incidence of umbilical hernias in cirrhotic patients is approximately 20%, higher than in the general population and occurs more on males than in females. These hernias tend to enlarge rapidly and have a marked predisposition for complications.

• #25 Umbilical hernia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/umbilical-hernia/symptoms-causes/syc-20378685

  An umbilical hernia occurs when part of your intestine bulges through the opening in your abdominal muscles near your bellybutton (navel). […] An umbilical hernia creates a soft swelling or bulge near the navel. It occurs when part of the intestine protrudes through the umbilical opening in the abdominal muscles. […] During gestation, the umbilical cord passes through a small opening in the baby’s abdominal muscles. The opening normally closes just after birth. If the muscles don’t join together completely in the midline of the abdominal wall, an umbilical hernia may appear at birth or later in life. […] In adults, too much abdominal pressure contributes to umbilical hernias. Causes of increased pressure in the abdomen include: Obesity, Multiple pregnancies, Fluid in the abdominal cavity, Previous abdominal surgery, Long-term peritoneal dialysis to treat kidney failure.

• #26 Umbilical hernia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/umbilical-hernia/symptoms-causes/syc-20378685

  An umbilical hernia occurs when part of your intestine bulges through the opening in your abdominal muscles near your bellybutton (navel). […] An umbilical hernia creates a soft swelling or bulge near the navel. It occurs when part of the intestine protrudes through the umbilical opening in the abdominal muscles. […] During gestation, the umbilical cord passes through a small opening in the baby’s abdominal muscles. The opening normally closes just after birth. If the muscles don’t join together completely in the midline of the abdominal wall, an umbilical hernia may appear at birth or later in life. […] In adults, too much abdominal pressure contributes to umbilical hernias. Causes of increased pressure in the abdomen include: Obesity, Multiple pregnancies, Fluid in the abdominal cavity, Previous abdominal surgery, Long-term peritoneal dialysis to treat kidney failure.

• #27 Umbilical Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459312/

  An umbilical hernia is a defect in the ventral abdominal fascia at or near the umbilicus. […] Approximately 90% of adult umbilical hernias are acquired. […] Stretching of the abdominal musculature and excess adiposity separate muscles and weaken aponeuroses, facilitating the occurrence of umbilical hernias. […] Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #28 Umbilical Hernia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30753

  Approximately 90% of adult umbilical hernias are acquired. […] Umbilical hernias are more common in persons with obesity, metabolic syndrome, ascites, and in those with a history of multiple pregnancies. […] Certain configurations of the umbilical ring can also influence the formation of an umbilical hernia. […] Any chronic or repetitive increase in intraabdominal pressure may increase the risk for an umbilical hernia, and there may be an association between the use of umbilical site laparoscopic trocars and umbilical hernias. […] Additional predisposing factors for adult umbilical hernias include connective tissue disorders, ethnic background, Beckwith-Wiedemann syndrome, Trisomy 21, and poor nutrition. […] Stretching of the abdominal musculature and excess adiposity separate muscles and weaken aponeuroses, facilitating the occurrence of umbilical hernias.

• #29 Pediatric Hernia Repair | Children’s Hospital Colorado

  https://www.childrenscolorado.org/doctors-and-departments/departments/pediatric-surgery/tests-procedures-services/hernia-repair/

  An umbilical hernia occurs at the belly button, or umbilicus. In most cases, umbilical hernias do not cause pain and can be gently pushed back into the abdomen. It is rare for umbilical hernias to become stuck (incarcerated), but if this occurs, your child should be seen by a physician as soon as possible. […] If this opening has not closed by the time a baby is born, it becomes an umbilical hernia. This hernia allows either tissue or fluid to enter the protruding sac, which causes the skin at the umbilicus to bulge outward. […] Umbilical hernias occur in approximately 20% of all newborns, but are more common in African Americans and premature infants. […] Umbilical hernias look like a bulge at the belly button that normally is soft and may appear and disappear. Most commonly, the hernia is noticed when the child strains, coughs or cries. Umbilical hernias can vary in size from very small to very large.

• #30 Umbilical hernia: when and how – Maia – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5123/html

  The incidence of umbilical hernias in adults ranges from 10% to 25% in the literature and is increased in females. Some predisposing factors for umbilical hernia development include pregnancy, obesity, ascites and large abdominal tumors leading to increased abdominal pressure. […] A true umbilical hernia is congenital and results from a failure of closure of the umbilical ring in the early years of life. In adults, umbilical hernias are usually acquired, defined as a defect from 3 cm above to 3 cm below the umbilicus and they are usually classified as indirect hernia. […] Some predisposing factors for the development of umbilical hernia include pregnancy, obesity, ascites and large abdominal tumor leading to increased abdominal pressure. […] Umbilical hernia repair in a cirrhotic patient with ascites is a very challenging scenario. In the past, most surgeons would avoid repairing any umbilical hernia in patients with more than Child-Pugh A liver cirrhosis unless in emergency situations. The incidence of umbilical hernias in cirrhotic patients is approximately 20%, higher than in the general population and occurs more on males than in females. These hernias tend to enlarge rapidly and have a marked predisposition for complications.

• #31 Umbilical hernia – Wikipedia

  https://en.wikipedia.org/wiki/Umbilical_hernia

  An umbilical hernia is a health condition where the abdominal wall behind the navel is damaged. It may cause the navel to bulge outwardsthe bulge consisting of abdominal fat from the greater omentum or occasionally parts of the small intestine. The bulge can often be pressed back through the hole in the abdominal wall, and may „pop out” when coughing or otherwise acting to increase intra-abdominal pressure. Treatment is surgical, and surgery may be performed for cosmetic as well as health-related reasons. […] The causes of umbilical hernia are congenital and acquired malformation, but an apparent third cause is really a cause of a different type, a paraumbilical hernia. […] An acquired umbilical hernia directly results from increased intra-abdominal pressure caused by obesity, heavy lifting, a long history of coughing, or multiple pregnancies.

• #32 Umbilical Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459312/

  An umbilical hernia is a defect in the ventral abdominal fascia at or near the umbilicus. […] Approximately 90% of adult umbilical hernias are acquired. […] Stretching of the abdominal musculature and excess adiposity separate muscles and weaken aponeuroses, facilitating the occurrence of umbilical hernias. […] Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #33 Umbilical Hernia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30753

  Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Patients with umbilical hernias often lack an umbilical fascia, and the round hepatic ligament may be abnormally attached to the inferior margin of the umbilical ring. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #34 Umbilical hernia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/umbilical-hernia/symptoms-causes/syc-20378685

  Complications can occur when the protruding abdominal tissue becomes trapped (incarcerated) and can no longer be pushed back into the abdominal cavity. This reduces the blood supply to the section of trapped intestine and can lead to abdominal pain and tissue damage. […] If the trapped portion of intestine is completely cut off from the blood supply, it can lead to tissue death. Infection may spread throughout the abdominal cavity, causing a life-threatening situation. […] Adults with umbilical hernias are somewhat more likely to experience a blockage of the intestines. Emergency surgery is typically required to treat these complications.

• #35 Umbilical Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459312/

  An umbilical hernia is a defect in the ventral abdominal fascia at or near the umbilicus. […] Approximately 90% of adult umbilical hernias are acquired. […] Stretching of the abdominal musculature and excess adiposity separate muscles and weaken aponeuroses, facilitating the occurrence of umbilical hernias. […] Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #36 Umbilical Hernia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30753

  Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Patients with umbilical hernias often lack an umbilical fascia, and the round hepatic ligament may be abnormally attached to the inferior margin of the umbilical ring. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #37 Umbilical hernia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/umbilical-hernia/symptoms-causes/syc-20378685

  Complications can occur when the protruding abdominal tissue becomes trapped (incarcerated) and can no longer be pushed back into the abdominal cavity. This reduces the blood supply to the section of trapped intestine and can lead to abdominal pain and tissue damage. […] If the trapped portion of intestine is completely cut off from the blood supply, it can lead to tissue death. Infection may spread throughout the abdominal cavity, causing a life-threatening situation. […] Adults with umbilical hernias are somewhat more likely to experience a blockage of the intestines. Emergency surgery is typically required to treat these complications.

• #38 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Umbilical hernias account for 10% of abdominal-wall hernias. Conditions that lead to increased intra-abdominal pressure and weakened fascia at the level of the umbilicus (eg, obesity, ascites, multiple pregnancies, and large abdominal tumors) contribute to the development of umbilical hernias. […] The most common symptom of umbilical hernias is pain at the umbilicus (44% of cases). Other complaints include pressure (20%) and nausea and vomiting (9%). Complications such as irreducibility, obstruction, strangulation, skin ulceration, and rupture are more common in paraumbilical hernias than in other abdominal hernias. […] All adult umbilical hernias should be repaired, owing to the high risk of complications. Indications for operative repair include the following: Pain, Incarceration, Strangulation, Defect larger than 1 cm, Skin ulceration, Hernia rupture.

• #39

  https://www.nhs.uk/conditions/umbilical-hernia-repair/what-happens/

  Umbilical hernia repair is a fairly quick and simple operation. It takes about 20 to 30 minutes and it’s usually possible to go home on the same day. […] During umbilical hernia repair, the surgeon makes a small cut at the base of the belly button and pushes the fatty lump or loop of bowel back into the tummy. The muscle layers at the weak spot in the abdominal wall where the hernia came through are stitched together to strengthen them. For large or adult umbilical hernias, a special mesh patch may be placed in the abdominal wall to strengthen the area instead. […] The wound on the surface of the skin is usually closed with dissolvable stitches.

• #40 Hernia Types, Causes, and Treatments | Columbia Surgery

  https://columbiasurgery.org/conditions-and-treatments/hernia-types-causes-and-treatments

  The goal of hernia repair surgery is to close the hernia defect with minimal or no tension to ensure that it does not recur. […] The mechanism of a hernia is like what happens with a bulge in a damaged tire, where the inner tube, normally contained by the hard rubber of the tire, extends through a thin or weakened place. […] The goal of hernia repair is to close the hernia defect with minimal or no tension to ensure that it does not recur. This occurs with or without mesh placement. […] Hernias requiring component separation would normally require a large midline incision, however centers adept at robotic component separation may only require 4-6 smaller incisions on the abdominal wall. This allows for a quicker recovery and reduces the rate of complications.

• #41

  https://www.nhs.uk/conditions/umbilical-hernia-repair/what-happens/

  Umbilical hernia repair is a fairly quick and simple operation. It takes about 20 to 30 minutes and it’s usually possible to go home on the same day. […] During umbilical hernia repair, the surgeon makes a small cut at the base of the belly button and pushes the fatty lump or loop of bowel back into the tummy. The muscle layers at the weak spot in the abdominal wall where the hernia came through are stitched together to strengthen them. For large or adult umbilical hernias, a special mesh patch may be placed in the abdominal wall to strengthen the area instead. […] The wound on the surface of the skin is usually closed with dissolvable stitches.

• #42

  https://www.nhs.uk/conditions/umbilical-hernia-repair/what-happens/

  Umbilical hernia repair is a fairly quick and simple operation. It takes about 20 to 30 minutes and it’s usually possible to go home on the same day. […] During umbilical hernia repair, the surgeon makes a small cut at the base of the belly button and pushes the fatty lump or loop of bowel back into the tummy. The muscle layers at the weak spot in the abdominal wall where the hernia came through are stitched together to strengthen them. For large or adult umbilical hernias, a special mesh patch may be placed in the abdominal wall to strengthen the area instead. […] The wound on the surface of the skin is usually closed with dissolvable stitches.

• #43 Adult Umbilical Hernia | ACS

  https://www.facs.org/for-patients/the-day-of-your-surgery/adult-umbilical-hernia/

  Most adult umbilical hernias are caused by increased abdominal pressure against a weak abdominal wall (acquired hernia). […] A hernia is strangulated if the intestine is trapped in the hernia pouch and the blood supply to the intestine is cut off. This is a surgical emergency and a bowel resection may also be needed. […] The type of operation depends on hernia size and location, and if it is a repeat hernia (recurrence). Your health, age, and the surgeon’s expertise are also important. An operation is the only treatment for a hernia repair. […] The use of mesh or other type of patch repair appears to reduce the rate of recurrence. […] The type of repair may also depend on the size of the hernia. […] The use of mesh provides a stronger repair and decreases the rate of recurrence.

• #44 Umbilical hernia repair: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/002935.htm

  Umbilical hernia repair is surgery to repair an umbilical hernia. An umbilical hernia is a sac (pouch) formed from the inner lining of your belly (abdominal cavity) that pushes through a hole in the abdominal wall at the belly button. […] Strong stitches will be used to repair the hole associated with the umbilical hernia. […] Surgery secures the weakened abdominal wall tissue (fascia) and closes any holes. […] There is always a chance that the hernia can come back. For healthy people, the risk of it coming back is very low.

• #45 Umbilical hernia repair: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/002935.htm

  Umbilical hernia repair is surgery to repair an umbilical hernia. An umbilical hernia is a sac (pouch) formed from the inner lining of your belly (abdominal cavity) that pushes through a hole in the abdominal wall at the belly button. […] Strong stitches will be used to repair the hole associated with the umbilical hernia. […] Surgery secures the weakened abdominal wall tissue (fascia) and closes any holes. […] There is always a chance that the hernia can come back. For healthy people, the risk of it coming back is very low.

• #46

  https://www.nhs.uk/conditions/umbilical-hernia-repair/what-happens/

  Umbilical hernia repair is a fairly quick and simple operation. It takes about 20 to 30 minutes and it’s usually possible to go home on the same day. […] During umbilical hernia repair, the surgeon makes a small cut at the base of the belly button and pushes the fatty lump or loop of bowel back into the tummy. The muscle layers at the weak spot in the abdominal wall where the hernia came through are stitched together to strengthen them. For large or adult umbilical hernias, a special mesh patch may be placed in the abdominal wall to strengthen the area instead. […] The wound on the surface of the skin is usually closed with dissolvable stitches.

• #47 Umbilical Hernia | Paraumbilical Hernia Surgery Singapore – Colorectal Practice Hernia

  https://www.hernia.sg/hernia-information/umbilical-hernia.html

  An umbilical hernia is typically repaired by either open surgery or laparoscopic (minimally invasive) techniques. […] In traditional open repair surgery, the surgeon makes a single incision over the navel to gain access to the hernia. The herniated tissue is then carefully pushed back into the abdominal cavity, and the weakened area of the abdominal wall is reinforced with stitches or a synthetic mesh patch to prevent a recurrence. […] This procedure involves making small incisions around the abdomen. The surgeon then inserts a specialised tube equipped with a tiny camera (laparoscope) through one of the incisions. The surgical tool transmits images to a monitor, allowing surgeons to view the abdominal cavity and treat hernias effectively. […] Although uncommon, there are potential risks and complications associated with umbilical hernia repair. These include: Infection at the surgical site, Fluid buildup around the wound (seroma), Hernia recurrence, Excessive bleeding at the incision site (haemorrhage), Breathing problems, Blood clots.

• #48 Umbilical Hernia | Paraumbilical Hernia Surgery Singapore – Colorectal Practice Hernia

  https://www.hernia.sg/hernia-information/umbilical-hernia.html

  An umbilical hernia is typically repaired by either open surgery or laparoscopic (minimally invasive) techniques. […] In traditional open repair surgery, the surgeon makes a single incision over the navel to gain access to the hernia. The herniated tissue is then carefully pushed back into the abdominal cavity, and the weakened area of the abdominal wall is reinforced with stitches or a synthetic mesh patch to prevent a recurrence. […] This procedure involves making small incisions around the abdomen. The surgeon then inserts a specialised tube equipped with a tiny camera (laparoscope) through one of the incisions. The surgical tool transmits images to a monitor, allowing surgeons to view the abdominal cavity and treat hernias effectively. […] Although uncommon, there are potential risks and complications associated with umbilical hernia repair. These include: Infection at the surgical site, Fluid buildup around the wound (seroma), Hernia recurrence, Excessive bleeding at the incision site (haemorrhage), Breathing problems, Blood clots.

• #49 Umbilical Hernia Repair Technique: Approach Considerations, Repair of Umbilical Hernia, Complications

  https://emedicine.medscape.com/article/2000990-technique

  Hernia repair with mesh should be considered for patients with defects larger than 4 cm. […] Open mesh repair of umbilical hernia appears to be associated with significantly lower recurrence rates than suture repair in adults. […] Laparoscopic repair should be considered for obese patients, patients with defects larger than 4 cm, and patients with recurrent hernias. […] For defects larger than 4 cm, a mesh onlay, sublay, or underlay should be used. […] Nonabsorbable 0 sutures are used to secure the mesh to the anterior abdominal wall. […] A secondary analysis (N = 55) of a randomized double-blinded trial conducted on female patients with primary umbilical hernia was carried out to determine the incidence of surgical site occurrences (SSOs) in onlay versus preperitoneal mesh placement in elective umbilical hernia repairs.

• #50 Umbilical Hernia Repair Technique: Approach Considerations, Repair of Umbilical Hernia, Complications

  https://emedicine.medscape.com/article/2000990-technique

  Hernia repair with mesh should be considered for patients with defects larger than 4 cm. […] Open mesh repair of umbilical hernia appears to be associated with significantly lower recurrence rates than suture repair in adults. […] Laparoscopic repair should be considered for obese patients, patients with defects larger than 4 cm, and patients with recurrent hernias. […] For defects larger than 4 cm, a mesh onlay, sublay, or underlay should be used. […] Nonabsorbable 0 sutures are used to secure the mesh to the anterior abdominal wall. […] A secondary analysis (N = 55) of a randomized double-blinded trial conducted on female patients with primary umbilical hernia was carried out to determine the incidence of surgical site occurrences (SSOs) in onlay versus preperitoneal mesh placement in elective umbilical hernia repairs.

• #51 Adult Umbilical Hernia | ACS

  https://www.facs.org/for-patients/the-day-of-your-surgery/adult-umbilical-hernia/

  Most adult umbilical hernias are caused by increased abdominal pressure against a weak abdominal wall (acquired hernia). […] A hernia is strangulated if the intestine is trapped in the hernia pouch and the blood supply to the intestine is cut off. This is a surgical emergency and a bowel resection may also be needed. […] The type of operation depends on hernia size and location, and if it is a repeat hernia (recurrence). Your health, age, and the surgeon’s expertise are also important. An operation is the only treatment for a hernia repair. […] The use of mesh or other type of patch repair appears to reduce the rate of recurrence. […] The type of repair may also depend on the size of the hernia. […] The use of mesh provides a stronger repair and decreases the rate of recurrence.

• #52 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Cirrhosis and uncontrolled ascites have been considered relative contraindications for elective open umbilical hernia repair. Owing to the increased surgical risk, elective repair is generally avoided in patients with Child-Pugh class B and C cirrhosis. […] Treatable conditions such as ascites and obesity should be addressed and treated in advance of elective repair. Obese patients should be counseled on weight loss before surgery. The mortality associated with repair in patients with uncontrolled ascites is reportedly 2%, and the recurrence rate is high. […] Recurrence rates associated with primary tissue repair have been reported to range from 15% to 40%. A systematic review and meta-analysis by Aslani and Brown showed a 10-fold decreased risk of recurrence in mesh repair as compared with primary suture repair. An increased risk of recurrence is seen in obese patients and defects larger than 3 cm.

• #53 Umbilical Hernia Repair Technique: Approach Considerations, Repair of Umbilical Hernia, Complications

  https://emedicine.medscape.com/article/2000990-technique

  Hernia repair with mesh should be considered for patients with defects larger than 4 cm. […] Open mesh repair of umbilical hernia appears to be associated with significantly lower recurrence rates than suture repair in adults. […] Laparoscopic repair should be considered for obese patients, patients with defects larger than 4 cm, and patients with recurrent hernias. […] For defects larger than 4 cm, a mesh onlay, sublay, or underlay should be used. […] Nonabsorbable 0 sutures are used to secure the mesh to the anterior abdominal wall. […] A secondary analysis (N = 55) of a randomized double-blinded trial conducted on female patients with primary umbilical hernia was carried out to determine the incidence of surgical site occurrences (SSOs) in onlay versus preperitoneal mesh placement in elective umbilical hernia repairs.

• #54 Umbilical Hernia Repair Technique: Approach Considerations, Repair of Umbilical Hernia, Complications

  https://emedicine.medscape.com/article/2000990-technique

  Hernia repair with mesh should be considered for patients with defects larger than 4 cm. […] Open mesh repair of umbilical hernia appears to be associated with significantly lower recurrence rates than suture repair in adults. […] Laparoscopic repair should be considered for obese patients, patients with defects larger than 4 cm, and patients with recurrent hernias. […] For defects larger than 4 cm, a mesh onlay, sublay, or underlay should be used. […] Nonabsorbable 0 sutures are used to secure the mesh to the anterior abdominal wall. […] A secondary analysis (N = 55) of a randomized double-blinded trial conducted on female patients with primary umbilical hernia was carried out to determine the incidence of surgical site occurrences (SSOs) in onlay versus preperitoneal mesh placement in elective umbilical hernia repairs.

• #55

  https://journals.lww.com/prsgo/fulltext/2023/04000/novel_approach_for_umbilical_hernia_repair_using.51.aspx

  The mesh strip technique for umbilical hernia repair has been described for larger repairs where there is a downside to the opening of additional tissue planes for the placement of a large mesh. Our mesh strip technique decreases the likelihood of suture pull-through by modulating the STI. […] A 2-cm strip of mesh provides 34 times the surface area of a number 1 polypropylene suture while minimizing the total volume of implanted foreign material. […] Biologically, this translates into lower pressures experienced by the tissues within a loop of suture, shielding the tissue from pressure-induced necrosis. […] A mesh strip repair permits synergy between the mechanical mesh construct and the biological healing response as the size and shape of the implant facilitates both issues. […] With a mean follow-up time of nearly 3 years, our recurrence rate of 3% after mesh strip umbilical hernia repair is comparable to recurrence rates for umbilical hernia repair with planar mesh (3.6%) and lower than simple suture repair (11.4%) as reported in a recent randomized clinical trial with 2-year follow-up.

• #56

  https://journals.lww.com/prsgo/fulltext/2023/04000/novel_approach_for_umbilical_hernia_repair_using.51.aspx

  The mesh strip technique for umbilical hernia repair has been described for larger repairs where there is a downside to the opening of additional tissue planes for the placement of a large mesh. Our mesh strip technique decreases the likelihood of suture pull-through by modulating the STI. […] A 2-cm strip of mesh provides 34 times the surface area of a number 1 polypropylene suture while minimizing the total volume of implanted foreign material. […] Biologically, this translates into lower pressures experienced by the tissues within a loop of suture, shielding the tissue from pressure-induced necrosis. […] A mesh strip repair permits synergy between the mechanical mesh construct and the biological healing response as the size and shape of the implant facilitates both issues. […] With a mean follow-up time of nearly 3 years, our recurrence rate of 3% after mesh strip umbilical hernia repair is comparable to recurrence rates for umbilical hernia repair with planar mesh (3.6%) and lower than simple suture repair (11.4%) as reported in a recent randomized clinical trial with 2-year follow-up.

• #57 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Umbilical hernias account for 10% of abdominal-wall hernias. Conditions that lead to increased intra-abdominal pressure and weakened fascia at the level of the umbilicus (eg, obesity, ascites, multiple pregnancies, and large abdominal tumors) contribute to the development of umbilical hernias. […] The most common symptom of umbilical hernias is pain at the umbilicus (44% of cases). Other complaints include pressure (20%) and nausea and vomiting (9%). Complications such as irreducibility, obstruction, strangulation, skin ulceration, and rupture are more common in paraumbilical hernias than in other abdominal hernias. […] All adult umbilical hernias should be repaired, owing to the high risk of complications. Indications for operative repair include the following: Pain, Incarceration, Strangulation, Defect larger than 1 cm, Skin ulceration, Hernia rupture.

• #58 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Umbilical hernias account for 10% of abdominal-wall hernias. Conditions that lead to increased intra-abdominal pressure and weakened fascia at the level of the umbilicus (eg, obesity, ascites, multiple pregnancies, and large abdominal tumors) contribute to the development of umbilical hernias. […] The most common symptom of umbilical hernias is pain at the umbilicus (44% of cases). Other complaints include pressure (20%) and nausea and vomiting (9%). Complications such as irreducibility, obstruction, strangulation, skin ulceration, and rupture are more common in paraumbilical hernias than in other abdominal hernias. […] All adult umbilical hernias should be repaired, owing to the high risk of complications. Indications for operative repair include the following: Pain, Incarceration, Strangulation, Defect larger than 1 cm, Skin ulceration, Hernia rupture.

• #59 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Umbilical hernias account for 10% of abdominal-wall hernias. Conditions that lead to increased intra-abdominal pressure and weakened fascia at the level of the umbilicus (eg, obesity, ascites, multiple pregnancies, and large abdominal tumors) contribute to the development of umbilical hernias. […] The most common symptom of umbilical hernias is pain at the umbilicus (44% of cases). Other complaints include pressure (20%) and nausea and vomiting (9%). Complications such as irreducibility, obstruction, strangulation, skin ulceration, and rupture are more common in paraumbilical hernias than in other abdominal hernias. […] All adult umbilical hernias should be repaired, owing to the high risk of complications. Indications for operative repair include the following: Pain, Incarceration, Strangulation, Defect larger than 1 cm, Skin ulceration, Hernia rupture.

• #60 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Umbilical hernias account for 10% of abdominal-wall hernias. Conditions that lead to increased intra-abdominal pressure and weakened fascia at the level of the umbilicus (eg, obesity, ascites, multiple pregnancies, and large abdominal tumors) contribute to the development of umbilical hernias. […] The most common symptom of umbilical hernias is pain at the umbilicus (44% of cases). Other complaints include pressure (20%) and nausea and vomiting (9%). Complications such as irreducibility, obstruction, strangulation, skin ulceration, and rupture are more common in paraumbilical hernias than in other abdominal hernias. […] All adult umbilical hernias should be repaired, owing to the high risk of complications. Indications for operative repair include the following: Pain, Incarceration, Strangulation, Defect larger than 1 cm, Skin ulceration, Hernia rupture.

• #61 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Umbilical hernias account for 10% of abdominal-wall hernias. Conditions that lead to increased intra-abdominal pressure and weakened fascia at the level of the umbilicus (eg, obesity, ascites, multiple pregnancies, and large abdominal tumors) contribute to the development of umbilical hernias. […] The most common symptom of umbilical hernias is pain at the umbilicus (44% of cases). Other complaints include pressure (20%) and nausea and vomiting (9%). Complications such as irreducibility, obstruction, strangulation, skin ulceration, and rupture are more common in paraumbilical hernias than in other abdominal hernias. […] All adult umbilical hernias should be repaired, owing to the high risk of complications. Indications for operative repair include the following: Pain, Incarceration, Strangulation, Defect larger than 1 cm, Skin ulceration, Hernia rupture.

• #62 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Umbilical hernias account for 10% of abdominal-wall hernias. Conditions that lead to increased intra-abdominal pressure and weakened fascia at the level of the umbilicus (eg, obesity, ascites, multiple pregnancies, and large abdominal tumors) contribute to the development of umbilical hernias. […] The most common symptom of umbilical hernias is pain at the umbilicus (44% of cases). Other complaints include pressure (20%) and nausea and vomiting (9%). Complications such as irreducibility, obstruction, strangulation, skin ulceration, and rupture are more common in paraumbilical hernias than in other abdominal hernias. […] All adult umbilical hernias should be repaired, owing to the high risk of complications. Indications for operative repair include the following: Pain, Incarceration, Strangulation, Defect larger than 1 cm, Skin ulceration, Hernia rupture.

• #63 Umbilical Hernia | Paraumbilical Hernia Surgery Singapore – Colorectal Practice Hernia

  https://www.hernia.sg/hernia-information/umbilical-hernia.html

  An umbilical hernia is typically repaired by either open surgery or laparoscopic (minimally invasive) techniques. […] In traditional open repair surgery, the surgeon makes a single incision over the navel to gain access to the hernia. The herniated tissue is then carefully pushed back into the abdominal cavity, and the weakened area of the abdominal wall is reinforced with stitches or a synthetic mesh patch to prevent a recurrence. […] This procedure involves making small incisions around the abdomen. The surgeon then inserts a specialised tube equipped with a tiny camera (laparoscope) through one of the incisions. The surgical tool transmits images to a monitor, allowing surgeons to view the abdominal cavity and treat hernias effectively. […] Although uncommon, there are potential risks and complications associated with umbilical hernia repair. These include: Infection at the surgical site, Fluid buildup around the wound (seroma), Hernia recurrence, Excessive bleeding at the incision site (haemorrhage), Breathing problems, Blood clots.

• #64 Umbilical Hernia Repair Technique: Approach Considerations, Repair of Umbilical Hernia, Complications

  https://emedicine.medscape.com/article/2000990-technique

  A study by Donovan et al (N = 979) found the following factors to be predictive of recurrence after open umbilical hernia repair: Higher body mass index (BMI), Concurrent laparoscopic inguinal hernia repair, Current smoking, Diabetes, Primary closure repair of hernias 1.5 cm, Postoperative infection.

• #65 Umbilical Hernia Repair Technique: Approach Considerations, Repair of Umbilical Hernia, Complications

  https://emedicine.medscape.com/article/2000990-technique

  A study by Donovan et al (N = 979) found the following factors to be predictive of recurrence after open umbilical hernia repair: Higher body mass index (BMI), Concurrent laparoscopic inguinal hernia repair, Current smoking, Diabetes, Primary closure repair of hernias 1.5 cm, Postoperative infection.

• #66 Umbilical Hernia Repair Technique: Approach Considerations, Repair of Umbilical Hernia, Complications

  https://emedicine.medscape.com/article/2000990-technique

  A study by Donovan et al (N = 979) found the following factors to be predictive of recurrence after open umbilical hernia repair: Higher body mass index (BMI), Concurrent laparoscopic inguinal hernia repair, Current smoking, Diabetes, Primary closure repair of hernias 1.5 cm, Postoperative infection.

• #67 Umbilical Hernia Repair Technique: Approach Considerations, Repair of Umbilical Hernia, Complications

  https://emedicine.medscape.com/article/2000990-technique

  A study by Donovan et al (N = 979) found the following factors to be predictive of recurrence after open umbilical hernia repair: Higher body mass index (BMI), Concurrent laparoscopic inguinal hernia repair, Current smoking, Diabetes, Primary closure repair of hernias 1.5 cm, Postoperative infection.

• #68 Umbilical Hernia Repair Technique: Approach Considerations, Repair of Umbilical Hernia, Complications

  https://emedicine.medscape.com/article/2000990-technique

  A study by Donovan et al (N = 979) found the following factors to be predictive of recurrence after open umbilical hernia repair: Higher body mass index (BMI), Concurrent laparoscopic inguinal hernia repair, Current smoking, Diabetes, Primary closure repair of hernias 1.5 cm, Postoperative infection.

• #69 Umbilical Hernia Repair Technique: Approach Considerations, Repair of Umbilical Hernia, Complications

  https://emedicine.medscape.com/article/2000990-technique

  A study by Donovan et al (N = 979) found the following factors to be predictive of recurrence after open umbilical hernia repair: Higher body mass index (BMI), Concurrent laparoscopic inguinal hernia repair, Current smoking, Diabetes, Primary closure repair of hernias 1.5 cm, Postoperative infection.

• #70 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Cirrhosis and uncontrolled ascites have been considered relative contraindications for elective open umbilical hernia repair. Owing to the increased surgical risk, elective repair is generally avoided in patients with Child-Pugh class B and C cirrhosis. […] Treatable conditions such as ascites and obesity should be addressed and treated in advance of elective repair. Obese patients should be counseled on weight loss before surgery. The mortality associated with repair in patients with uncontrolled ascites is reportedly 2%, and the recurrence rate is high. […] Recurrence rates associated with primary tissue repair have been reported to range from 15% to 40%. A systematic review and meta-analysis by Aslani and Brown showed a 10-fold decreased risk of recurrence in mesh repair as compared with primary suture repair. An increased risk of recurrence is seen in obese patients and defects larger than 3 cm.

• #71

  https://journals.lww.com/prsgo/fulltext/2023/04000/novel_approach_for_umbilical_hernia_repair_using.51.aspx

  The one patient with a recurrence developed this complication in the setting of recurrent ascites, a known independent risk factor for umbilical hernia recurrence. […] We introduce a novel mesh strip repair of umbilical hernias that blends the simplicity of suture repair with the advantageous force distribution properties of mesh.

• #72 Umbilical Hernia Repair: Background, Indications, Contraindications

  https://emedicine.medscape.com/article/2000990-overview

  Cirrhosis and uncontrolled ascites have been considered relative contraindications for elective open umbilical hernia repair. Owing to the increased surgical risk, elective repair is generally avoided in patients with Child-Pugh class B and C cirrhosis. […] Treatable conditions such as ascites and obesity should be addressed and treated in advance of elective repair. Obese patients should be counseled on weight loss before surgery. The mortality associated with repair in patients with uncontrolled ascites is reportedly 2%, and the recurrence rate is high. […] Recurrence rates associated with primary tissue repair have been reported to range from 15% to 40%. A systematic review and meta-analysis by Aslani and Brown showed a 10-fold decreased risk of recurrence in mesh repair as compared with primary suture repair. An increased risk of recurrence is seen in obese patients and defects larger than 3 cm.

• #73

  https://journals.lww.com/prsgo/fulltext/2023/04000/novel_approach_for_umbilical_hernia_repair_using.51.aspx

  The mesh strip technique for umbilical hernia repair has been described for larger repairs where there is a downside to the opening of additional tissue planes for the placement of a large mesh. Our mesh strip technique decreases the likelihood of suture pull-through by modulating the STI. […] A 2-cm strip of mesh provides 34 times the surface area of a number 1 polypropylene suture while minimizing the total volume of implanted foreign material. […] Biologically, this translates into lower pressures experienced by the tissues within a loop of suture, shielding the tissue from pressure-induced necrosis. […] A mesh strip repair permits synergy between the mechanical mesh construct and the biological healing response as the size and shape of the implant facilitates both issues. […] With a mean follow-up time of nearly 3 years, our recurrence rate of 3% after mesh strip umbilical hernia repair is comparable to recurrence rates for umbilical hernia repair with planar mesh (3.6%) and lower than simple suture repair (11.4%) as reported in a recent randomized clinical trial with 2-year follow-up.

• #74 Umbilical Hernia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30753

  Approximately 90% of adult umbilical hernias are acquired. […] Umbilical hernias are more common in persons with obesity, metabolic syndrome, ascites, and in those with a history of multiple pregnancies. […] Certain configurations of the umbilical ring can also influence the formation of an umbilical hernia. […] Any chronic or repetitive increase in intraabdominal pressure may increase the risk for an umbilical hernia, and there may be an association between the use of umbilical site laparoscopic trocars and umbilical hernias. […] Additional predisposing factors for adult umbilical hernias include connective tissue disorders, ethnic background, Beckwith-Wiedemann syndrome, Trisomy 21, and poor nutrition. […] Stretching of the abdominal musculature and excess adiposity separate muscles and weaken aponeuroses, facilitating the occurrence of umbilical hernias.

• #75 Umbilical Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459312/

  An umbilical hernia is a defect in the ventral abdominal fascia at or near the umbilicus. […] Approximately 90% of adult umbilical hernias are acquired. […] Stretching of the abdominal musculature and excess adiposity separate muscles and weaken aponeuroses, facilitating the occurrence of umbilical hernias. […] Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #76 Umbilical Hernia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30753

  Umbilical hernias tend to occur in areas of potential fascial weakness, such as the attenuation in the linea alba immediately adjacent to the umbilicus or where the umbilical vessels, especially the umbilical vein, perforate the abdominal wall. […] Patients with umbilical hernias often lack an umbilical fascia, and the round hepatic ligament may be abnormally attached to the inferior margin of the umbilical ring. […] Additional factors contributing to the development of an umbilical hernia include conditions that chronically increase intraabdominal pressure, such as ascites, chronic constipation, and heavy lifting. […] The diameter of the neck of the hernia defect can be narrow compared to the size of the hernia sac; the lifetime risk of incarceration and strangulation is between 1% and 3%. […] During the pathophysiologic progression to strangulation, venous drainage and, ultimately, arterial inflow are disrupted, leading to infarction of the omentum and bowel.

• #77

  https://www.east.org/education-resources/landmark-papers-in-trauma-and-acute-care-surgery/emergency-general-surgery/umbilical-hernia

  Mesh versus suture repair of umbilical hernia in adults: a randomized, double-blind, controlled, multicenter trial concluded that mesh repair should be used on all umbilical hernia repairs of size 1-4cm as mesh repair significantly reduces the rate of recurrence compared to suture primary repair. […] This retrospective analysis compares patch repair using ready-made synthetic mesh versus sutured repair of umbilical hernias and showed that the use of dense fascia suturing (short-stitch technique) may be an effective alternative to patch repair in patients with no significant risk factors for recurrence to avoid the higher risk of postoperative pain with mesh repair. […] Recent review of available literature on cirrhotic umbilical hernia.

• #78

  https://link.springer.com/article/10.1007/s10029-024-03165-y

  There is variation in the investigation, management, and surgical technique of acutely symptomatic umbilical hernias and optimal strategies remain to be established. […] This survey aims to identify key variables that influence surgeon decision-making and preferred surgical techniques in emergency umbilical hernia care. […] The most favoured trial design, comparing mesh and suture repair and antibiotics versus no antibiotics, holds promise in addressing several key uncertainties surrounding emergency umbilical hernia repair. […] Assessing SSI at 90 days and hernia recurrence at 1 year is pivotal in gauging the effectiveness and safety of mesh and suture repairs. […] The survey findings indicate that post-operative antibiotics are less frequently routinely administered compared to pre- and intra-operative antibiotics, with common indications including wound contamination, hernia content, and the use of mesh.

• #79

  https://link.springer.com/article/10.1007/s10029-024-03165-y

  Hernia recurrence is an important outcome when evaluating the success of hernia repair. […] A higher rate of hernia recurrence in suture repair has also been noted in the emergency setting, however evidence is lacking. […] The execution of such a trial is not devoid of complexities. […] It appears that despite some variation, a trial comparing mesh and suture repair and also antibiotics versus no antibiotics could potentially be delivered with eligibility criteria of defect width up to 5 cm, and CDC wound classifications ranging from 1 to 3, thus ensuring the inclusion of a representative patient cohort and maximising its generalisability. […] The identified variations in surgical techniques and perioperative care highlight the need for well-designed RCTs to inform evidence-based practice.

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