Umbilical Hernia

Question 1

Definition of umbilical hernia

Answer 1

Primary hernia with center of defect in middle umbilical ring

Question 2

What are the classifications of umbilical hernias?

Answer 2

Small (0-1cm), medium(1-4cm), large(>4cm)

Question 3

What is the difference between umbilical and paraumbilical hernias

Answer 3

1. Location of hernia
2. Epidemiology (Common in africa, infants and children vs common in adult women)
3. Acquired causes

Question 4

What is the clinical presentation of a patient with umbilical hernia

Answer 4

Hx:
Intermittent abdominal pain, colic from intermittent intestinal obstruction

Risk factors: Smoking, steroids

PE:
Inspect and palpate like normal hernia

Question 5

What are the concerns of umbilical hernias?

Answer 5

Narrow neck of hernia sac predisposes to strangulation

Fistula formation may occur

Question 6

What is the management of umbilical hernia

Answer 6

Depending on size

<1cm - Primary surgical repair

between 1 and 4cm - sublay open mesh repair

Question 7

What are the complications of hernia surgery

Answer 7

Injury to viscera
Seroma/hematoma
Wound infection
Recurrence (especially when the mesh is not big enough)