Umbilical hernia

Abstract

One case of congenital umbilical hernia may be encountered in every five thousand deliveries. One third of the cases of congenital umbilical hernia will have more than one congenital defect. Careful inspection of the cord will preclude the ligation of a loop of intestine in a small congenital hernia. The hernial defect must be closed early and preferably within the first six hours. An inguinal hernia will be present in about 30 per cent of the infants with an infantile umbilical hernia. As a rule surgery should not be instituted for an infantile umbilical hernia before five years of age. Strangulation occurs in one of every eight umbilical hernias of the adult type. A mortality of 1 to 3 per cent for surgical repair of the umbilical hernia is increased to 30 to 50 per cent in the presence of strangulation. Adequate weight reduction is important and voluminous hernias should be subjected to an abdominal binder for a period of time. The surgical repair is best accomplished by the Mayo transverse fascial overlap.