OBSTRUCTED UMBILICAL HERNIA -

Umbilical Hernia is one of the commonest type of Ventral ( Abdominal wall ) hernia.

Omentum ( Fatty tissue covering the bowels ) or a loop of intestine herniates through a defect in the abdominal wall at the umbilicus.

Causes are -

• Excess pressure over Abdominal muscles
• Weakening or Thinning of Abdominal wall muscles
• Obesity

The commonest aggravating factor is multiple pregnancies.

Hernia becomes more prominent on standing &/or straining and initially disappears on lying down.

In advances stages, the contents may not reduce on their own , but may have to be reduced manually.

Complications are -

• Obstruction- where the passage of the herniated loop gets obstructed causing Severe Abdominal pain, Vomiting, Abdominal Distention & Constipation. This requires emergency surgery to relieve the obstruction.
• Strangulation - Blood supply to the herniated bowel is hampered causing Gangrene of the content. It requires an emergency surgery where the affected part of the bowel needs to be resected and the healthy part is to be anastomosed.

Treatment - Treatment for umbilical Hernia is only surgical & must be planned as soon as the condition is diagnosed by the surgeon, to prevent above mentioned complications.

Surgery can be an Open surgery ( Preferred in large Hernia or During Emergency surgery for complicated Hernia or when the patient is not fit for General Anaesthesia )

Minimal Access Approach is preferred in planned surgeries. It can be either a Robotic Assisted surgery ( Preferred now a days ) or a Laparoscopic Approach. Minimal Access Technique gives better results and helps in quick recovery.

Here I am showing Photographs of Obstructed Umbilical Hernia which had to be Operated by an Open method.

Pre-Operative Photograph

Dusky Looking Loop of Small Bowel as Obstructed content

Normal Colour of the Bowel Restored after Relieving the Obstruction

Repair done using Polypropylene Mesh after Reducing the Intestinal Loop