Does infant umbilical hernia need treatment?

Written by Zhang Xian Hua
Pediatrics
Updated on February 14, 2025
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Infant umbilical hernia is caused by poor congenital development of the navel, resulting in protrusion of the umbilicus. Usually, as the child ages, the hernial ring gradually narrows and closes, and 80% of such cases can close on their own. However, there are a few cases, such as those where the hernial ring diameter is too large, especially more than 2cm, or those that do not close by the age of two, which require surgical treatment. During this period, it is usually necessary to avoid situations that may cause increased abdominal pressure in the child, leading to protrusion of the navel, such as preventing the child from crying intensely. For instance, if the child exhibits gastrointestinal symptoms, they should be taken to the doctor for timely examination and treatment.

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Written by Zhang Xian Hua
Pediatrics
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Is an umbilical hernia in infants serious?

Infant umbilical hernia is caused by a weak abdominal wall around the navel, which is underdeveloped, leading to protrusion. This is prone to happen when intra-abdominal pressure is high. Therefore, it's usually sufficient to avoid intense crying in children and actively treat gastrointestinal diseases without special treatment. This is because 80% of infants will naturally see the hernia ring narrow, or even close by itself by the age of two, leading to healing. Only a few children, if the hernia ring diameter is large, more than 2 cm, or if the umbilical hernia is still evident after the child turns two, will require surgical treatment.

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Written by Zhang Peng
General Surgery
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Is umbilical hernia hereditary?

Umbilical hernia is not a hereditary disease and generally does not occur genetically. Umbilical hernia is due to the incomplete healing of the umbilical ring, causing the abdominal organs to protrude through the umbilical ring, and is a congenital disease. Developmental inadequacies of the navel, or the presence of scar tissue, thinness, and lack of toughness in the navel area can lead to this condition when abdominal pressure increases. In general, children with an umbilical hernia may show discomfort, which can manifest as frequent crying or constipation. For most cases of umbilical hernia, conservative treatment is an option. In children under two years old, surgery can be avoided by using adhesive tape treatment, which can achieve very good therapeutic effects. If the diameter of the umbilical ring is still greater than 1.5 cm after the age of two, timely surgery is necessary. For adults with umbilical hernia, incarceration and strangulation are common, and surgery is recommended as soon as a clear diagnosis is made.

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Written by Zhang Peng
General Surgery
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How is umbilical hernia treated?

In treating umbilical hernias, we need to consider both the age of the patient and the size of the hernia specifically caused. Generally, children under the age of two do not require surgery. Typically, we consider using a coin or cardboard larger than the umbilical ring, wrapping it up, pressing against the umbilical ring, and securing it with adhesive tape to prevent movement. Most can close by themselves and heal. For children over two years old, if the hernia is still larger than 1.5cm, surgical treatment should be considered. In adults, traditional tissue repair methods are generally used, or an open umbilical hernia tension-free repair. The repair can be placed in front of the muscle or can use a hernia ring filling method. For most patients, if there is an opportunity for minimally invasive treatment, laparoscopic umbilical hernia repair can be selected. This method generally involves a smaller incision and can preserve the navel, reducing the chance of incision infection, and is particularly suitable for obese patients.

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Written by Zhang Peng
General Surgery
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The difference between umbilical hernia and umbilical protrusion

Umbilical hernia refers to a condition in children where the umbilical ring does not close during development, causing a defect in the abdominal wall. This situation can be treated conservatively. Within half a year, the effects are generally good. You can choose a coin larger than the umbilical ring or cover it with a flat board, press it against the umbilical ring, and then use adhesive tape to fix it to prevent movement. Generally, most patients can heal on their own. If the diameter of the umbilical ring still exceeds 1.5 cm after two years old, it is advisable to actively accept surgical treatment. Moreover, the protrusion may not involve a defect in the abdominal wall but a potential weakness in the abdominal wall at the navel. Under conditions of increased abdominal pressure, there can be a protruding appearance at the navel. The biggest difference from an umbilical hernia might be that the umbilical protrusion might present a lump that does not completely disappear. In the case of an umbilical hernia, if the contents can be returned to the abdominal cavity, the hernia can disappear completely.

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Written by Zhang Peng
General Surgery
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What will happen if an umbilical hernia is not treated?

If umbilical hernia is not treated, in general, adults are more likely to experience incarceration or strangulation. For children with umbilical hernias, conservative observation is usually adopted, and surgery is not necessary within the first two years unless incarceration occurs. During the waiting period, adhesive tape fixation can be used as a treatment method. If the umbilical hernia is larger than two weeks, and the diameter of the umbilical ring is generally more than 1.5 cm, surgical treatment is required. For children over five years old, regardless of the situation, it is advisable to undergo timely surgery. Adults with umbilical hernias are generally advised to have surgery as soon as possible. The surgical methods typically include traditional tissue repair or open tension-free hernia repair. For patients suitable for laparoscopic treatment, laparoscopic surgery is chosen as it causes less trauma and allows for the preservation of the umbilicus without extensive dissection, no need for drainage placement, and a very low chance of wound infection.