1. An umbilical hernia is a protrusion of abdominal contents through the abdominal wall near the umbilicus. 2. It can be congenital, due to incomplete closure of the umbilical ring, or acquired later in life due to risk factors like obesity, pregnancy, or ascites. 3. Physical exam reveals a soft, reducible mass at the umbilicus that increases in size with straining; complications include incarceration or strangulation which require surgery.

1. Umbilical
Hernia

2. HERNIA:
Protrusion of a part or structure
through the tissues normally
containing it.
Abdominal
Wall Hernia
Inguinal Femoral Umbilical Others
UmbilicalHernia

3. Umbilical hernia :
Part of the intestine or fatty tissue
bulges through the muscle near
umbilicus.
Umbilical
Hernia
Congenital
Acquired
UmbilicalHernia

4. UmbilicalHernia
Topics of Presentation :
1.Introduction & definition.
2.Anatomy.
3.Causes & risk factors.
4.History.
5.Physical Examination.
6.Investigations.
7.Management.
8.Complications.

5. UmbilicalHernia
ANTERIOR ABDOMINAL WALL:
Anatomy

6. UmbilicalHernia
UMBILICAL RING:

7. UmbilicalHernia
Causes & risk factors
Infant :
1. Incomplete closure of umbilical opening.
2. premature babies and those with low
birth weights.
3. Black infants.
Adults :
1. Obesity.
2. Multiple pregnancies.
3. Fluid in the abdominal cavity (ascites).
4. Previous abdominal surgery.
5. Chronic peritoneal dialysis.

8. UmbilicalHernia
History
- Sewlling Hx.
- Predisposing factors questions.
- Complication quistions.
- Past surgical hx.

9. UmbilicalHernia
 Swelling Hx. :
- Where is it ?
- When did you notice it ?
- Did you notice it by your self ?
- How did you notice it ?

10. UmbilicalHernia
 Swelling Hx. :
- Does it disappears ?
- Is there any change in it’s size,
shape and color ?
- Did you had a previous similar
case?
- Do you have any other lumps?

11. UmbilicalHernia
 Predisposing factors :
- Did you have a chronic cough ?
- Do you have a chronic constipation?
- Do you lift heavy objects ?
- Multiparous or not ?

12. UmbilicalHernia
 Complication symptoms :
- Did you have abdominal pain ?
- Do you have abdominal distension ?
- Do you have vomiting ?

13. UmbilicalHernia
Systemic review :
- Respiratory system.
- Gastrointestinal symptoms.
- Urinary system.

14. UmbilicalHernia
- Previous surgeries .
- Past medical Hx.
- Social Hx.

15. UmbilicalHernia
PHYSICAL EXAMINATION
• Identify The hernia.
• Look for a mass in the area of the
fascial defect.
• Define the borders of the fascial
defect.
• The size of the fascial defect and
whether it is circular provide
management clues.
• Generally asymptomatic , it may cause
mild discomfort in some children.
• Central, mid abdominal bulge.
Hypertrophic, hyperpigmented

16. UmbilicalHernia
- Easily reduced hernial sac with well-
defined border of fascia
central defect of variable diameter.
- The overlying skin may appear stretched
and proboscoid (redundant and
protuberant).
- If presents with tenderness, incarceration
with or without strangulation should be
suspected.
- Symptoms of bowel obstruction include
vomiting, abdominal pain, and constipation.

17. UmbilicalHernia
- Strangulated hernias are
differentiated from incarcerated
hernias by the following:
1. Pain out of proportion to
examination findings.
2. Fever or toxic appearance.
3. Pain that persists after
reduction of hernia.

18. UmbilicalHernia
INVESTIGATIONS
An umbilical hernia is diagnosed
during a physical exam. Sometimes
imaging studies — such as an
abdominal ultrasound or CT scan —
are used to screen for complications
Complications from umbilical hernias
rarely occur in children. However,
additional complications can occur in
both children and adults if the
umbilical cord is incarcerated.

19. UmbilicalHernia
INVESTIGATIONS
• CBC
• X–Ray
• US
• Lactate level.

20. UmbilicalHernia
MANAGEMENT
(INFANT)
• Observation and reassurance as
these defects typically close by
age 4 or 5 years.
*Except for symptomatic patient and
hernia > 2cm.
• Any defects that persist beyond 5
years should undergo surgical
repair.

21. UmbilicalHernia
MANAGEMENT
(ADULT)
- When to do surgery?
- Special consideration:
Obese, chronic cough,
constipation….etc.

22. UmbilicalHernia
UMBILICAL
HERNIORRHAPHY

23. UmbilicalHernia
HERNIOPLASTY

24. UmbilicalHernia
Additional lipectomy
(panniculectomy)

25. UmbilicalHernia
IN CASE OF STRANGULATION

26. UmbilicalHernia
COMPLICATIONS
- Incarceration.
- Strangulation.
- Perforation.

27. UmbilicalHernia
POSTOPERATIVE
COMPLICATIONS
- Postoperative pain.
- Recurrence.
- Hernia at the port site.

28. UmbilicalHernia
- Hematoma.
- Seroma.
- Wound infection.

29. UmbilicalHernia
SOURCES
 Uptodate.
 American College of
Surgeons.
 Medscape.

30. UmbilicalHernia
DONE BY ..
- Abdullah Alnewirah.
- Abdulaziz Bagasi.
- Eyad Alterazi.
- Adel Alshehri.
- Moayad Fallatah.
- Suhib Baaremah.
- Baraa Alim.
- Ahmed Taher.