Other hernias

Key points

Umbilical hernia different to hernia of the cord, in which there is also a defect in the peritoneum

Umbilical hernia results from absence or weakness of Richets fascia, derived from transversalis fascia

Lumbar hernias present after birth

Associations of umbilical hernia

• Beckwith-Weidemann Syndrome

• Trisomy 13, 18, 21

• Increased intra-abdominal pressure, dialysis etc

• Hurlers syndrome:

  • Mucopolysaccharidosis type I

  • Developmental impairment

  • Umbilical and inguinal hernias

  • Skeletal and cardia defects

Proboscoid umbilical hernias may be closed in first 2 years of life as unlikely to resolve

May require v-y umbilicoplasty

Incarceration of umbilical and epigastric hernias is rare

May indicate anatomical abnormality such as a Meckel's band if it occurs in an umbilical hernia

Umbilical hernias resolve 3-4 years of age

Epigastric, lumbar and spigelian do not resolve

Page edited by Mrs Charnjit Seehra BSc November 2024

References

Holcomb and Ashcraft’s Pediatric Surgery, 7th edition, 2020, Chapter 49