Umbilical Hernia In Children: Treatment Overview

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Treatment Overview

Almost all umbilical hernias close on their own without treatment, usually by the time the child is 1 year of age. If an umbilical hernia does not close on its own by age 5, surgical repair usually is needed. For more information, see:

Should my child have surgery for an umbilical hernia?

Types of surgery that may be done include:

• Umbilical hernia repair. Umbilical hernia repair is the main surgery used for an umbilical hernia that does not correct itself. It is usually an outpatient procedure with low risk. Your child can go home the same day surgery is performed. During the procedure, your child is given general anesthesia. A small incision is made just below the navel (umbilicus), and any loops of the intestines and other tissue that have protruded into the hernia sac are pushed back inside the abdomen. Then the muscles and connective tissues of the umbilical ring are repaired, and the incision is closed, leaving a small scar inside the navel.
• Surgery to improve the appearance of the navel. Sometimes the navel looks abnormal after surgery. This is more likely to occur if the umbilical hernia was very large or if excess skin was over the hernia (proboscoid hernia). In these cases, additional surgical techniques may be used to help improve how the navel looks.

Problems caused by umbilical hernia surgery are very rare but may include:

• Infection.
• Localized swelling caused by the accumulation of fluid at the site of the wound (seroma).
• Bleeding or blood clots at the site of the wound (hematoma).
• Recurrence of the hernia.
• Part of the intestine being injured during surgery.

What to Think About

Surgery to repair an umbilical hernia before a child is 5 years old is usually not necessary. But surgery may be performed earlier if:

• The hernia is large [ or more across] and has not shown any signs of closing on its own by age 2 years.
• The child or the parents want the hernia repaired for social, cosmetic, or other reasons. This may be a consideration if the child has a proboscoid hernia. Some children or their parents may find this type of hernia distressing, or the child may play with or irritate the protrusion of skin.
• Complications, such as a loop of the intestines becoming trapped in the hernia sac (incarceration or strangulation), require emergency surgery.

Last updated:	January 23, 2008
Author:	Caroline Rea, RN, BS, MS
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Brad W. Warner, MD - Pediatric Surgery
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC