The origin, fate and significance of the umbilical hernia in Nigerian children (A review of 1,300 cases)

Abstract

1. (1) The results of a survey to determine the incidence, etiology and significance of umbilical herniae in Nigerian children are described. 2. (2) Ninety-seven per cent. of newborn babies were found to have the skin type of umbilicus. 3. (3) Umbilical herniae were found in 91 per cent. of a group of children aged from 1 month to 5 years, 64 per cent. in those aged 6 to 9 years and 46 per cent. in those aged 10 to 15 years. In a group of well-nourished adults, 14 per cent. were positive. In a malnourished group 27 per cent. were positive. 4. (4) The natural history of the umbilicus in the Nigerian child is discussed. The importance of the skin type of umbilicus and of a wide umbilical ring in the etiology of umbilical herniae is stressed. The harmless character of the condition is noted. 5. (5) The incidence of umbilical hernia in children in other parts of the world is briefly surveyed. 6. (6) It is concluded that umbilical herniae are very much more common in West African children, and probably all African children, than in children in other ethnic groups. 7. (7) It is suggested that this is due to two inherited physiological characteristics — the skin type of umbilicus and the wide umbilical ring.