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Incarceration of umbilical hernia in children: is the trend increasing?
1Paediatric Surgery, Guy's and St Thomas' Hospital NHS Trust, London, UK. alireza.keshtgar@gstt.sthames.nhs.uk
Insights
Umbilical hernias in children typically close on their own. However, recent cases suggest complications like incarceration may be increasing, challenging the standard expectant management approach.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Developmental Pediatrics
Background:
- Umbilical hernias are common congenital abdominal wall defects in infants and children.
- Spontaneous closure is the typical natural history, usually occurring within the first three years of life.
- Complications such as incarceration and strangulation are considered rare, supporting a non-operative management policy until age five.
Observation:
- Seven pediatric cases of complicated umbilical hernias were managed over a three-year period.
- A review of epidemiological trends in pediatric abdominal wall defects was conducted.
- An increasing incidence of umbilical hernia incarceration was noted.
Findings:
- The study identified a potential increase in the incarceration rate of umbilical hernias in children.
- This trend may necessitate a re-evaluation of the current expectant management guidelines.
- Epidemiological data suggests a possible link between changing trends in abdominal wall defects and hernia incarceration.
Implications:
- Current non-operative management guidelines for umbilical hernias may need revision.
- Increased surveillance or earlier surgical intervention might be considered for pediatric umbilical hernias.
- Further research into the epidemiological factors influencing pediatric umbilical hernia complications is warranted.
Abstract:
Umbilical hernias are common in infants and young children. The natural history of umbilical hernia is spontaneous closure, usually in the first 3 years of life. Complications of incarceration or strangulation of an umbilical hernia are believed to be rare. Therefore, an expectant policy of non-operative management until at least 5 years of age has been considered acceptable. We have managed seven children with complications of umbilical hernia in the past three years. We have reviewed the epidemiological changes in the incidence of abdominal wall defects in children and postulated a possible relationship to the increasing trend of incarceration of umbilical hernias.
