Dr. Ertan Beyatlı

About Umbilical Hernia

(Update: ) - Hernia

A hernia in the umbilicus Umbilical Hernia called. Hernia holes can be anywhere in the navel. In the middle, below, above, on the sides or above.

Wherever they are, these hernias are called Umbilical or Umbilical Hernia in Latin.

Contents

Why and how does it occur?

The reasons are as follows:

  • Congenital hernias: Umbilical hernias that occur in babies at birth.
  • Increased intra-abdominal pressure: Heavy lifting, obesity, pregnancy, abdominal compression
  • Iatrogenic: Hernias that develop especially after closed (laparoscopic) surgeries.

Formations in the abdominal cavity (intestine, gut membranes, omentum, etc.) pops out through a hole in the abdominal wall (herniation).

The membrane that comes out from the abdomen is called hernia sac. (peritoneum). In time, serious adhesions occur between the formations in the abdomen and the hernia sac and cause some chronic upper digestive complaints.

Umbilical hernia anatomy - The orange line is the fascia and it is noteworthy that it does not persist in the area of ​​the hernia.
Anatomy of an umbilical hernia - The orange line is the fascia and it is noteworthy that it does not persist in the area of ​​the hernia.

How is this situation understood?

This disease is often painless. In cases where there are complaints, either the disease is advanced or complications have developed. The following symptoms may occur in patients:

  • Pain. In and around the belly; especially when suppressed; pain and a feeling of heaviness can be seen. Sometimes the location of the pain can vary (wandering or wandering pain). In most patients, the pain is usually in the left part of the navel. Although rare, pain can also be felt on the right, top and bottom of the navel. In some patients, the pain does not have a specific area and only a vague and ambiguous pain.
  • Swelling. Disappearance or flattening of the belly button. Swelling, edema and tenderness in and around the belly. A chickpea or walnut-sized mass in the belly, protrusion or enlargement of the belly. Bad and foul-smelling discharge and / or blood from the navel. Swelling and stiffness in the belly are more intense in people who frequently practice traditional practices.
  • Swelling. Does umbilical hernia cause gas? Yes, in cases of suffocation (incarceration or strangulation) there may be gas bloating in the abdomen. Complaints of shortness of breath, low back pain and inability to stand upright due to increased pressure in the abdomen.

Digestive system complaints can also be seen in cases of complications. For example; extreme and unbearable abdominal pain, nausea, vomiting, anorexia, constipation, occasionally diarrhea and fire can be seen. In addition, focusing problems, headaches, inattention and fatigue can be seen. In these cases, there may be discoloration (bruising, redness) on the skin in the navel.

How is the diagnosis made?

Physical abdominal examination performed by the physician is essential. In addition to the examination, films such as Ultrasound, tomography and MRI can also be taken. Sometimes tests, examinations and analysis can be clean. X-ray, ultrasound, tomography and MR films may not be able to distinguish the hernia sac.

Harm and Danger

These people adopt a different lifestyle to reduce complaints. What they eat, drink, their tastes, morale and hobbies are not what they want. They start living as required by this unresolved discomfort.

If this condition is not treated, it progresses over time and may cause unwanted distress. For example:

  • Intestines and omentum may enter the pouch, in this case stomach pain and can cause constipation
  • As a result of the compression of the formations in the hernia sac, blood supply may be impaired. This situation bowel rot may cause. This is a life-threatening condition.
  • In time, irritated bowel walls may tear and bowel perforation or explosion may occur.

Is there a cure?

Time required: 45 minutes.

The treatment method for umbilical hernias is surgery. There are many methods for surgery. Surgeries can be done by putting them to sleep, numbing the waist, or just numbing the belly. (General, spinal and local anesthesia).

  1. Skin incision (skin incision)

    At this stage, an incision is made on the lower, upper, middle or side of the navel.

  2. Herniated Pouch

    After the skin and subcutaneous tissues are passed, a hernia sac is found. If there is no formation in the pouch, it is directly repaired. If there is formation in the pouch (intestine, omentum, etc.), it is placed in the abdomen (reduced) again. Adherent omentum parts and adipose tissues can be excised.

  3. Abdominal repair

    The opening in the abdominal membrane (fascia defect) is repaired by sewing. Patches can be used for some large defects.

  4. Closure of the skin

    The skin and subcutaneous tissues are sewn properly again and the procedure is terminated.

In closed surgeries (laparoscopic), 3 or 4 holes are made in the anterior abdominal wall and the hernia sac is repaired from the inside.

After Umbilical Hernia Treatment

I usually give some advice to my patients after surgery:

Dressing. Keeping the wound area clean, dressing on time (preferably on days 5 and 10). It is important that the dressings are made in a clean and healthy environment so that the surgical wound does not become inflamed.

Stitches. Most of the time, absorbable stitches are applied and do not need to be removed after surgery. (see absorbed stitches).

Medicines. Paying attention to the regular use of post-operative medicines as prescribed. Not using any drugs other than those prescribed.

Diet. Consumption of small amounts of foods and preferably watery foods so as not to cause constipation for the first 2-3 days after surgery.

Its. Drinking plenty of water (1.5-2 L daily)

Spor. Regular walking. Avoiding extreme sports activities for at least a month. Protecting the operation area from impacts or friction that may come from outside.

Do not pull up heavy thing. It is appropriate not to lift heavy for at least 6-8 weeks after the operation. Surgical sutures may be damaged if lifted heavily during this period.

Abdominal Belly Corset. It is appropriate to use a belly brace for at least 1-2 months. In some patients, longer periods may be required (eg in cases of obesity, diabetes). It is also inconvenient to use the abdominal corset longer than necessary, and the abdominal muscles may be damaged (atrophy) why could it be.

Frequently Asked Questions FAQ

Some common questions are asked by many patients both on the internet and during the examination. I can summarize my answers to these questions like this:

What is the water sac in the navel?

The term water sac in the belly means a hernia sac. The pouch consists of three parts: mouth, neck and body. The risk of suffocation is higher in pouches with narrow mouth and neck parts. Large hernia sacs are removed during surgery, and small sacs are placed back into the abdominal cavity.

Will there be a hernia after gallbladder surgery?

Nowadays, closed biliary surgery for gallstones (Laparoscopic Cholecystectomy) has become the gold standard. In these surgeries, several holes are made in the abdominal wall to enter some instruments (eg endocamera, endo-dissector, etc.). Surgery is performed with these tools with the help of the port.

As standard, 4 holes are drilled, 2 of them are 10mm and 2 of them are 5mm. Sometimes the fascia defect in the 10mm holes in the umbilical pit expands over time after the surgery and may cause herniation. It is colloquially called Umbilical Hernia, but its real medical name Port-location Incisional herniabecause it is not a spontaneous hernia.

When the navel is pressed, why does it beat elsewhere?

Scientifically, there is no such situation. When pressed to the navel, especially in weak people, carotid artery (abdominal aorta) beats can be felt. This is normal. Since the pain caused by umbilical hernia is close to this area, it is common among the public that these pains are related to beats.

What is its English?

Umbilical Hernia is the English language of the hernias that occur in the navel. Herniated holes above the navel (supra-umbilical hernia), below (infra-umbilical hernia) or on the sides of the navel (para-umbilical hernia) can be.

Is it an obstacle to pregnancy?

Umbilical hernia does not prevent pregnancy. However, in some pregnancies, the umbilical ring expands and loosens. This situation can lead to post-pregnancy herniation.

Does an umbilical hernia cause constipation or diarrhea?

In some cases, a part of the intestines is compressed inside the umbilical hernia sac and causes excessive intestinal peristalsis (in denial or stangule hernia). In these cases, diarrhea and / or constipation and swelling in the abdomen.

Which doctor to go to?

For umbilical hernia, go to the General Surgery specialist. Before the hernia is diagnosed, internal medicine or gastroenterology departments can be visited for pain in the belly.

What if I don't have surgery?

Hernias are a disease that progresses over time and causes complications. If the umbilical hernia is not operated on, it may cause intestinal strangulation and decay or obstruction in the future (see Umbilical Hernia Damages).

Is a patch (mesh) put in the surgery?

In small-diameter defects, Mayo Repair can be applied as an autograft from its fascia. In fascia defects of 4-5 cm in diameter and above, a patch (mesh) can be placed in the area. Then the belly button (umbilicus, umbilicus) is repaired (umbilicoplasty, umbilicoplasty). The average duration of this surgery is 30 minutes.

How is umbilical hernia treated in newborns?

In newborn babies, umbilical hernia may close spontaneously. Therefore, it is useful to wait 3-4 years after birth.

What is a belly brace?

It is a corset that is generally used after umbilical hernia surgery. It supports the abdominal wall muscles and prevents damage to the operation area. The period of use is 2-6 months. Sometimes it is used by patients who do not have surgery. In such cases, it is aimed that the hernia does not go out any longer.

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