What is an umbilical hernia?

An umbilical hernia is a lump at the umbilicus (belly button).

The abdominal cavity contains the intestines and other structures. These are protected by the abdominal wall, which is made up of four layers. The inner layer is a membrane. The second layer is a wall made of muscle. A layer of fat separates the muscle from the outer layer of skin.

Weak spots can develop in the layer of muscle, resulting in the contents of the abdomen, along with the inner layer, pushing through the abdominal wall. This produces a lump called a hernia.

What are the benefits of surgery?

Your child should no longer have the hernia. Surgery should prevent your child from having any of the serious complications that a hernia can cause in adult life, and allow them to return to normal activities.

Are there any alternatives to surgery?

It is unusual for an umbilical hernia to cause serious problems such as the bowel getting stuck in the hernia. So it is safe, in children, to see if the hernia will close without surgery.

If your child is over 3 years old and they still have an umbilical hernia, the hernia is unlikely to close.

What will happen if I decide not to have the operation or the operation is delayed?

Occasionally, the hernia can get larger with time. The hernia can also be dangerous in an adult because the intestines or other structures within the abdomen can get trapped and have their blood supply cut off (strangulated hernia).

The symptoms that may suggest a strangulated hernia are:

• severe pain
• a hernia that will not disappear when your child lies down
• vomiting

If your child has any of these symptoms you must call the healthcare team immediately as your child may need an urgent operation.

Although umbilical hernias hardly ever cause these complications in childhood (risk: less than 3 in 1,000), they are more likely to do so in adulthood.

What does the operation involve?

The operation is performed under a general anaesthetic and usually takes about an hour.

Your surgeon will make a small cut around the upper or lower half of the umbilicus and close the opening in the tough layer of the abdominal wall with strong stitches.

What can I do to prepare my child for the operation?

Your child should try to maintain a healthy weight. They will have a higher risk of developing complications if they are overweight.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• bleeding
• infection of the surgical site (wound)
• allergic reaction to the equipment, materials or medication

Specific complications of this operation

• developing a lump under the wound caused by stitches, or a collection of blood or fluid
• injury to structures within the hernia that come from the abdomen
• unsightly appearance, as the skin of the umbilicus may continue to stick out

Consequences of this procedure

• pain
• unsightly scarring of the skin

How soon will my child recover?

They should be able to go home the same day.

Your child should be able to return to school after a week but for 6 weeks should not do strenuous exercise.

Most children make a full recovery.

Summary

An umbilical hernia is a common condition. If your child is over 3 years old, surgery is recommended to prevent serious complications that can happen in adult life.

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