Umbilical Hernia Symptoms, Causes and Imaging

An umbilical hernia is a common finding found on imaging studies of the abdomen.  This is a hernia in the region of the belly button. Many are small  and asymptomatic.  They can however at times present as an emergency when complicated.

What is an umbilical hernia

An umbilical hernia is a protrusion of abdominal fat or intestine beyond a weak spot along the umbilicus (belly button) and abdominal wall.

Those which are small in size are often asymptomatic.  They can however be symptomatic as they get larger.  They can contain intestine and develop complications.

Umbilical hernia causes

In children, this can be because of a developmental failure of the abdominal wall to close, leaving a defect.

In adults, it is more common in women and those who have increased pressure in their abdomen.  Common reasons include: pregnancy, obesity, liver failure and fluid in the abdomen (ascites).

Umbilical hernia symptoms

There is often a protrusion in the region of the belly button and abdominal wall.  This can be asymptomatic when small and present with discomfort and pain as it enlarges.  Some hernias contain intestine.  Those hernias which become complicated can become painful, have skin discoloration, nausea, vomiting and even death.

Umbilical hernia on CT scan

CT scans can diagnose an umbilical hernia.  CT will also tell us if the hernia contains abdominal fat only or intestine as well.  We can also see associated complications.  An inflamed umbilical hernia becomes concerning for strangulation. CT scan can tell us if the intestine is obstructed by the hernia.

Umbilical hernia complications

Incarcerated umbilical hernia

This means that the hernia can not be pushed back into the abdomen.  This is often a clinical diagnosis your doctor makes.

Strangulated umbilical hernia

This means that the hernia is being deprived of blood supply.  This can be especially dangerous when the hernia contains intestine.  Intestine deprived of blood can become deadly.  We can sometimes see inflammation and changes of the intestine which suggests strangulation.

Bowel obstruction

An umbilical hernia with intestine in it can cause a bowel obstruction.  This can be dangerous and needs an emergency surgical consultation.

Umbilical hernia treatment

In general, a surgeon should manage these hernias.   These hernias often require repair to prevent complications.  Those hernias which are strangulated or associated with bowel obstruction need emergency surgery.

Umbilical hernia: summary

Umbilical hernias are commonly seen on imaging of the abdomen.  Many are small and asymptomatic containing fat.  Those which are larger and contain intestine can become symptomatic and develop complications.  Hernias which are complicated can be life threatening and need prompt surgical treatment.  CT scans are valuable for diagnosing hernias and complications.