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HERNIA
Small with a narrow neck – is a configuration that increases the risk of strangulation and incarceration.
Omentum, small bowel, and colon can be found within the sac.
A direct or true umbilical hernia consists of a symmetric protrusion through the umbilical ring and is seen in neonates or infants.
Indirect umbilical (paraumbilical) hernias protrude above or below the umbilicus and are the most common type of umbilical hernia in adults.
All adult umbilical hernias should be repaired, owing to the high risk of complications.
Here is a list of indications to consider:
Pain
Incarceration
Strangulation
Defect larger than 1 cm
Skin ulceration
Hernia rupture
Incarceration or strangulation is a particular concern in pregnant patients.
Patients should be instructed to avoid heavy lifting for 2-4 weeks postoperatively.
Obese patients should be counseled on strategies for weight management.
Continued medical control helps to decrease the risk of recurrence in patients with ascites.
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