Practice 10-Minute Consultation

Umbilical hernia

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4252 (Published 19 July 2013) Cite this as: BMJ 2013;347:f4252
  1. L Barreto, clinical research fellow in paediatric surgery 1,
  2. A R Khan, associate specialist in paediatric surgery1,
  3. M Khanbhai, general practitioner2,
  4. J L Brain, consultant paediatric surgeon1
  1. 1Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 2QQ, UK
  2. 2Watling Medical Centre, NHS GP Surgery, Burnt Oak, Middlesex HA8 0NR
  1. Correspondence to: A R Khan arkhan{at}doctors.org.uk
  • Accepted 7 May 2013

A healthy 2 year old girl presented with an asymptomatic umbilical hernia. Her parents are concerned about the appearance and are worried that she will be teased when she goes to school.

Background

  • A true umbilical hernia is a defect in the anterior abdominal wall underlying the umbilicus, through which the intestine can protrude.

  • This skin covered defect results from delayed contraction of the fibro muscular umbilical ring. Spontaneous closure can occur up to the age of 4 or 5 years, depending on the size of the defect.

  • The incidence of umbilical hernia is higher in African and Afro-Caribbean infants. It occurs with equal frequency in boys and girls.

What you should consider during the consultation

On examination, umbilical hernias should be distinguished from paraumbilical hernias. Paraumbilical hernias are situated just above the umbilicus, and unlike umbilical hernias, have no potential …

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