If the contents of the hernia are intestinal tubes, intestinal peristalsis can be seen; the hernia protrudes when standing upright and returns when lying down; there is a coughing sensation of impact, and the umbilical defect and round hernia ring can be palpated on retraction. So, what conditions should be differentially diagnosed with the symptom of a half spherical mass in the umbilicus? The following is a brief introduction: umbilical bulge: umbilical bulge (acromphalus) is a common type of congenital abdominal wall developmental malformation, which is a neonatal malformation caused by congenital abdominal wall hypoplasia, forming an abdominal wall defect around the umbilical cord, resulting in the prolapse of abdominal viscera. Because the disease is associated with chromosomal abnormalities, children with umbilical bulge may also have malformations of other organs. The mortality rate is very high when not treated properly. The vast majority of children need surgery immediately after birth, otherwise it is difficult to survive due to local skin breakdown, necrosis and infection. In a few cases, the cystic membrane gradually fibroses to form a scar, thus protecting the detached viscera and avoiding early death. The mortality rate of this disease is related to the time of treatment and should be operated as early as possible when available. Umbilical sores: The symptoms include redness and swelling of the umbilicus, confined to the umbilicus in mild cases, or spreading to the surrounding area in severe cases, or even erosion and overflowing of pus, accompanied by fever, irritability, red lips and dry mouth. In adults, umbilical hernia is not self-healing and is prone to entrapment and strangulation, so all should be treated surgically. However, surgical treatment is contraindicated in patients with ascites secondary to hepatic sclerosis and in elderly patients with severe cardiac and pulmonary disorders who cannot tolerate surgery, and emergency surgery should still be performed in case of incarceration or strangulation.