A protruding mass in the umbilicus is one of the symptoms of umbilical hernia in infants and children, a congenital developmental defect disorder that decreases with age. Most can heal spontaneously within 2 years of age. The surface of the hernia is covered with skin mainly manifested by a protruding swelling in the umbilicus, which increases when crying, and the skin is tense and thin with a slight greenish color The swelling shrinks and disappears when lying down or sleeping quietly, leaving a loose fold in the umbilicus. Examination of infants with protruding masses in the umbilicus: Generally, only an abdominal X-ray is needed to understand whether there are signs of intestinal obstruction. The abdominal percussion, which is an auxiliary examination used to check whether the abdomen is normal. The clinical diagnosis of infant umbilical hernia is usually made with the following clinical signs and symptoms The umbilical scar is a congenital weakness after the umbilical cord has fallen off, and the anterior and posterior sheaths of the rectus abdominis muscles on both sides do not close together during infancy, leaving a defect, which creates the conditions for an umbilical hernia to occur. The hernia sac is a protruding peritoneum covered with skin and a thin layer of connective tissue between the skin and the peritoneum, and the protruding viscera are mostly small intestine and large omentum, which rarely become embedded. 1.After birth, the umbilicus of the infant is a semicircular swelling bulge, mostly the size of a thumb, soft in texture, and the umbilical scar can be seen in the lower half of the swelling. The swelling enlarges when the baby cries or strains, and shrinks or disappears when the baby rests quietly or is squeezed by hand. The hernia ring can be palpated after returning the hernia contents by hand, and the diameter of the ring is usually less than 2.0 cm. The diagnosis of adult umbilical hernia is relatively easy, and an accurate diagnosis can usually be made after detailed questioning of the symptoms and careful physical examination. For those who have difficulty in diagnosis, ultrasonography is also an option. Differential diagnosis of umbilical hernia in infants: A general hernia refers to a hernia in the groin, mainly because the muscles somewhere near the full canal of the groin are weaker, causing the nearby small intestine to be squeezed into the groin canal by abdominal pressure, and if it occurs in male babies, it may even run into the scrotum, making the affected side of the groin and scrotum look particularly enlarged in appearance. Differences: A groin hernia is more often associated with abdominal pain, vomiting and other gastrointestinal congestion than an umbilical hernia. Similarities: The time for emergency surgery is when the small intestine is strangulated or blocked, when local tenderness, swelling and abnormal color are often present. Expert tip: Most umbilical hernias in infants can heal on their own within 2 years of age, and as the abdominal muscles develop with age, the hernia hole can often be gradually narrowed and closed, so no treatment is needed. However, if the age is above 4 years or the diameter of the umbilical ring is more than 2-3 cm, surgery should be considered to remove the hernia sac and repair the abdominal wall defect.