Adult umbilical hernia is rare, and it is rare for adults to have a giant and incarcerated umbilical hernia, and such a special case happened to 72-year-old Auntie Liu. Six months ago, Auntie Liu’s belly button bulged up like a balloon, as if she was pregnant for six to seven months. The swelling of the stomach is very obvious when standing, and the swelling “disappears” when lying down. Since she did not feel any discomfort, Auntie Liu did not care. Until she was hospitalized for cirrhosis, the swelling in her abdomen became abnormally “arrogant” and could not be “recovered” even when lying down, and she also had paroxysmal cramps in her abdomen, accompanied by nausea. The swelling in Auntie Liu’s abdomen was 18cm in diameter, which is a rare type of huge incarcerated umbilical hernia. This type of umbilical hernia requires immediate surgical treatment, otherwise intestinal obstruction and intestinal necrosis can occur. Often referred to as small bowel gas, a hernia is not a puff of gas, but a part of body tissue or organ that leaves its original site and enters another site through a gap, defect or weak part of the body. Depending on where it occurs, common hernias include umbilical hernia, inguinal hernia, hiatal hernia, incisional hernia, and white line hernia. Most hernias are caused by coughing, sneezing, excessive force, excessive abdominal fat, forceful defecation, pregnancy in women, excessive crying in children, and degenerative changes in the strength of the abdominal wall in the elderly. The umbilicus is the weakest part of the abdomen and is most easily breached. Once the abdominal muscles are overstretched, the internal organs, mostly the small intestine and colon, will come out from the weak spot around the umbilicus. In fact, a hernia is like a torn piece of clothing, if not repaired in time, the hole will only get bigger and bigger. Especially in adults, hernia cannot heal itself and the swelling will keep increasing, making it prone to impaction or strangulation, so it should not be ignored and should be treated promptly. How to treat hernia? For the treatment of hernias, the most commonly used surgical procedure is laparoscopic inguinal hernia repair, which uses a laparoscope to repair the hernia from the inside of the abdominal wall and then lays down the artificial omentum, with only a few small wounds on the abdominal wall, significantly reducing postoperative pain. Conventional surgery typically uses sutures to pull the weak or defective tissue closed. Although this method repairs the hernia, the tension created by this pulling of the tissues often leads to the formation of a new area of weakness, making hernia recurrence a difficult problem to solve. With advances in material science and medical technology, tension-free repairs are now being introduced. This type of repair applies a high-tech patch to repair the weak area that exists and is also called a tension-free hernia repair because the patch avoids the tension created by the tissue stitches. This type of repair has led to a significant reduction in the recurrence rate of hernia surgery, which is below 2%. For hernia repair, it is like sewing on a garment. If the hole in the garment is large, sewing the hole directly with a needle is not strong, whereas if a piece of cloth is padded under the hole and then sewn carefully, it will naturally be stronger. The need to place a foreign body to repair a hernia is also a concern for many patients. In fact, most of the repair materials used in modern tension-free hernia repair are high-purity polypropylene materials, which are highly inert, not easily chemically reactive with tissues, and have good histocompatibility. Experts remind that a hernia that cannot be retracted is called an “incarcerated hernia”, which causes abdominal pain and a tense, hard mass. If the incarcerated hernia is prolonged, it is important not to blindly push the mass back into the abdominal cavity. Because the embedded intestine may be ischemic and necrotic, there is a risk of intestinal necrosis and perforation if it is forced back into the abdominal cavity. For such patients should immediately go to the hospital for treatment, do not have a fluke, so as not to delay treatment.