Incarcerated umbilical hernia in children

Abstract

Introduction: Umbilical hernia is common in infants and children. The true incidence is unknown because many umbilical hernias resolve spontaneously. Historically, incarceration is considered rare (1-2); however, it seems to occur more frequently than it is generally believed. Most of the literature related to incarceration comes from African countries, where the black community predominates. It should be noted that umbilical hernias tend to occur more commonly in the African population; nearly 10 times more, than in whites. It seems that this trend is increasing in France and England as well, where most of the population is white. The same change appears to be happening in Iran. Materials and Methods: A retrospective analysis of umbilical hernias at our institution was performed. Patients presented to our institution over a period of eight months, from March 21st to October 20th 2006. Results: Of the fifteen cases of umbilical hernias during the 8 month 4 had incarceration (26%). There were 3 girls (75%) and 1 boy (25%). In all the 4 cases of incarceration hernias had a diameter of more than 1.5 cm. Two patients underwent manual reduction and the hernia was repaired the following morning and two patients underwent operation the same day the symptoms began, since the hernia was irreducible. Intestinal resection was not indicated in any of our patients; however omental resection was done in one of them. All patients had an uneventful postoperative course and there was no mortality. Conclusion: Incarcerated umbilical hernia is not as uncommon as it was thought to be. Therefore, a more active therapeutic approach is recommended even in smaller hernias.