Umbilical hernia in adults: symptoms, treatment, photos, causes

Umbilical hernia is one of the varieties of abdominal hernia, which is the exit of the internal organs of the abdominal cavity through the hernial gates into the subcutaneous fatty tissue.

As the organs that can be in the hernial sac, act: loops of thin and / or large intestine, a large omentum, stomach.

"Weak" place of exit of internal organs in this pathology is the umbilical ring.

Umbilical hernia can occur both in female and male populations. However, most often this disease occurs in women giving birth and small children.

Newborn hernia appears almost immediately after birth. The most predisposed to the emergence of this pathology are premature babies. In addition, children at risk include children with Down's disease, congenital hypothyroidism, lactase deficiency, and intestinal dysbacteriosis.

Causes of umbilical hernia

The reasons for umbilical hernia formation are somewhat different in children and adults. The main etiologic factors of the development of abdominal hernias in children include:

1. 1) Defect in the development of the tissues of the anterior abdominal wall( including poor development of the umbilical ring muscles).The causes of this phenomenon are: infectious diseases of the mother, transferred during pregnancy, the effect of toxic substances on the mother's body, excessive physical overstrain;
   
2. 2) Increased intra-abdominal pressure( observed with frequent screaming and crying).

The main reasons for the appearance of umbilical hernia in adults are:

• weakness of the muscular layer of the anterior abdominal wall;
  
• pregnancy and advanced labor in women( in particular, if there were several), complicated labor in any period of childbirth;
  
• weakness of connective tissue localized in the umbilical ring region;
  
• previous operative interventions on the abdominal organs;
  
• traumatic injuries of the anterior abdominal wall( including postoperative scars), abdominal trauma;
  
• excessive physical activity;
  
• prolonged coughing;
  
• frequently occurring constipation and straining during defecation;
  
• obesity or vice versa, a sharp loss of body weight;
  
• ascites.

Classification

Depending on the time of appearance, place of exit and the presence of complications, umbilical hernias are divided into several types.

By the time of onset, hernias are divided into:

1. 1) Congenital( embryonic umbilical hernia, as well as embryonic umbilical hernias);
   
2. 2) Purchased( in adults and people).

Depending on the site of the exit of the hernial protrusion from the abdominal cavity, all umbilical hernias are divided into:

1. 1) Straight( the hernial sac leaves directly through the umbilical ring);
   
2. 2) Slanting( hernial protrusion leaves the gap between the transverse fascia and the white abdominal line, and then passes through the umbilical ring.)
   These hernias are located under the umbilical ring or above it).

By the presence of complications:

1. 1) Restricted;
   
2. 2) Unsupported.

Symptoms of umbilical hernia in adults

In adults, umbilical hernia can easily be diagnosed already according to clinical symptomatology. The very first symptom of the disease is the appearance of a soft protrusion of an oval or round shape in the navel.

The protrusion disappears on its own when the patient lies on the back. In addition, uncomfortable hernias with ease are adjusted with a finger.

As the hernial protrusion grows, patients can make complaints about pain in the abdomen of varying degrees of intensity, the appearance of which is provoked by physical stress, coughing, sneezing. In addition, there is the appearance of constipation, nausea, vomiting, widening of the umbilical ring. Often patients with umbilical hernia lose appetite.

Over time, the umbilical hernia in adults becomes uncontrollable. This is due to the fact that between the hernial sac and the abdominal wall are formed adhesions that disrupt the ability to move the hernia inside the umbilical ring.

In the presence of signs of infringement: nausea, vomiting, intense soreness, the inability to correct the hernia, the presence of traces of blood in the feces, the change in the color of the skin in the near-umbilical region( there is hyperemia, and after the skin acquires a dark, sometimes somewhat cyanotic shade)intervention.

See also: symptoms of inguinal hernia in men.

Possible complications

Long-term non-disturbing umbilical hernia at a particular time can actively manifest itself and cause anxiety to the patient.

Umbilical hernia can be complicated:

1. 1) Stiffening( squeezing the contents of the hernial sac with a hernial graft leading to necrosis of parts of organs located in the hernial sac);
   
2. 2) Attachment of secondary infection, the appearance of inflammation of part of the organ that is in the hernial sac;
   
3. 3) Coprostasis( if intestinal loops are involved in the pathological process).

Diagnosis of hernia

Diagnosis of the umbilical hernia is quite simple. Clinical symptoms immediately suggest the idea of ​​a true diagnosis. However, it is worth remembering the need for differential diagnosis with other diseases.

To this end, it is recommended to conduct a number of instrumental research methods, among which the following are considered to be particularly informative:

• examination and palpation of formation( finger-guided);
  
• ultrasound of hernial protrusion;
  
• ;
  
• herniography - a technique that allows you to examine a hernia after the introduction of a contrast medium into the abdominal cavity;
  
• X-ray of the stomach and duodenum.

Treatment of umbilical hernia

Treatment of umbilical hernia in children and adults is somewhat different.

Due to the fact that with age the muscular layer of the anterior abdominal wall of the child gradually strengthens, there is no need for surgical intervention.

For the treatment of umbilical hernias until the age of five, conservative therapy is used, which consists in carrying out specialized massage of the umbilical ring, physiotherapy exercises and gymnastics. Equally important is the balanced diet of the baby. From this, products that enhance gas generation and make it difficult to move away from the chair should be excluded.

For the treatment of umbilical hernia in adults, this type of surgical intervention, such as hernioplasty, is used."Classical" hernioplasty is performed using the methods of Mayo and Sapezhko.

The essence of the operation is to suture the enlarged umbilical ring with two layers. You can suture it in both the transverse and longitudinal direction. Often the operation requires removal of the navel. Unfortunately, this technique does not give a 100% guarantee that the hernia does not form again.

In addition, the shortage of this method is extremely long postoperative rehabilitation - throughout the year the person who transferred such hernioplasty should limit physical activity.

Currently, a wide spread in the treatment of umbilical hernias has acquired hernioplasty using specialized mesh implants. With such surgery, implants can be placed above the umbilical ring( right under the skin) or under the umbilical ring( under the aponeurosis).Such plasticity gives an extremely low percentage of possible relapse, as well as a short rehabilitation period.

Currently, laparoscopic hernioplasty is widely used, requiring minimal cutaneous incisions. Gernioplasty, like any other surgical intervention, has a number of contraindications to the procedure. The main contraindications that prohibit surgical treatment include the following:

• chronic infectious diseases in the acute stage;
  
• malignant formation;
  
• concomitant pathology of internal organs( including hepatitis C);
  
• immunodeficiency states;
  
• period of menstruation in women.

If the surgical treatment can not be performed, the patient must have a life-supporting support bandage for life( except for sleep time).

See also how to treat inguinal hernia.

Prevention

The basis of preventive measures that help to avoid the appearance of umbilical hernia, include:

• tracking body weight;
  
• wearing bandage by pregnant women;
  
• training of abdominal muscles;
  
• feasible lifting of weights;
  
• treatment of major diseases that can cause an increase in intra-abdominal pressure;
  
• clear compliance with all the surgeon's recommendations in the postoperative period;
  
• gymnastics and massage for newborns.

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