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Abstract: Umbilical hernia is a disease in which tissue in the abdominal cavity is prolapsed through the umbilical ring. The incidence is higher in infants, and most adult umbilical hernias are caused by long-term elevated intra-abdominal pressure due to acquired factors. The adult umbilical hernia was mainly manifested as a reversible umbilical mass. After diagnosis, she was actively treated surgically, and the postoperative result was good, and the umbilical mass disappeared without leaving any obvious scar.
Basic information】Female, 29 years old
Disease Type】Umbilical hernia
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of consultation】January 2022
Treatment plan】Surgical treatment (laparoscopic tension-free repair of umbilical hernia)
Treatment Period】6 days of hospitalization and 6 months of follow-up
Results】The umbilical mass disappeared, leaving no obvious scar and no recurrence so far
I. Initial consultation
The patient, Ms. Xia, reported that she was pregnant two years ago and gave birth to her baby at full term. However, she developed a mass in her umbilicus due to excessive intra-abdominal pressure during the second trimester of pregnancy. The umbilical hernia itself is not painful and can be returned by itself after lying down, so over time, Ms. Xia did not pay attention to it and put it off again and again. On examination: the umbilical mass was about 5 cm in size and could be retracted, with no pressure pain, regular shape, clear border, no pressure pain and rebound pain in the abdomen, and no other obvious abnormalities. Outpatient ultrasound suggested umbilical hernia, so she was admitted to the hospital with umbilical hernia.
(Ultrasound showed that the umbilical hernia sac was enlarged in the upright position and could be retracted when lying down)
II. Treatment history
After Ms. Xia was admitted to the hospital, the routine admission examination was completed, and I communicated with her in detail, and Ms. Xia and her family agreed to the surgical treatment, so I immediately arranged for Ms. Xia to complete the preoperative examination, excluded the contraindication to surgery, and combined with Ms. Xia’s needs, a laparoscopic tension-free repair of umbilical hernia was proposed to be performed under general anesthesia the next day. The patch was trimmed and sutured to the anterior abdominal wall and cosmetically closed with absorbable thread, and Ms. Xia returned to the ward safely. Postoperatively, Ms. Xia was fasted from food and water for 6 hours, her medication was changed regularly, and she was given injectable ceftriaxone sodium to prevent infection as well as rehydration and nutritional support. Because Ms. Xia reported that her pain was mild and tolerable, no pain medication was applied. Five days after the operation, Ms. Xia recovered well from the incision, walked freely, and her diet and bowel movements returned to normal.
Treatment effect
Ms. Xia came to our hospital for surgical treatment of her umbilical hernia, and considering her young and aesthetic needs, she was given minimally invasive surgery with cosmetic sutures. The outpatient review after 1 month showed that the patch was not displaced, indicating a good surgical result, and the outpatient review after 3 months showed that Ms. Xia did not show any signs of recurrence and had resumed normal life.
IV. Notes
We are glad that Ms. Xia’s symptoms have improved after treatment, but we still need to pay attention to the following care matters.
1, after discharge from the hospital should pay attention to daily care, regular change of medication, avoid water exposure of the incision, the temperature outside is low, should pay attention to warmth, to avoid sneezing and other cold symptoms, which is not conducive to wound healing.
2. actively improve dietary habits, eat more light and easily digestible food, avoid stimulation by spicy and cold food, eat more fruits and vegetables to supplement vitamins, drink more water and keep bowel movements smooth to avoid constipation, which may lead to increased abdominal pressure and re-trigger umbilical hernia.
Therefore, Ms. Xia should listen carefully to the doctor’s advice, follow up regularly after discharge, and make a reasonable subsidized treatment plan in time according to the postoperative recovery, so as to avoid recurrence of umbilical hernia or infection of the incision.
V. Personal insight
Ms. Xia, who loves beauty, was very grateful to me and I felt happy for her as her umbilical hernia mass disappeared after reasonable treatment without leaving any obvious scar. Most people do not know about umbilical hernia, which is an extra-abdominal hernia formed by the protrusion of abdominal contents outward from the weak area of the umbilicus, and it is not common in clinical practice, mostly in infants and children due to incomplete closure of the umbilical ring. Most patients, like Ms. Xia, do not pay attention to the umbilical hernia because it is not uncomfortable and wait until the mass grows gradually before going for treatment, which leads to increased difficulty and risk of surgery. Umbilical hernia can basically be cured after standard treatment, and recurrence is rare and the prognosis is good.