Foreign body causing obstructed umbilical hernia in a 2-year-old girl; A case report

Umbilical hernia (UH), quite prevalent in pediatric population, may rarely present with serious complications like incarceration or viscus organ strangulation. An incarcerated hernia is the one which cannot be reduced back whereas, strangulation results when blood supply to the entrapped tissue is compromised.

A 2-year-old female child, with history of reducible umbilical swelling since birth, presented in the emergency department with signs of acute obstruction. Examination favored an irreducible umbilical hernia to be the cause of the patient's clinical condition. Provisional diagnosis was further strengthened by emergency investigations including abdominal ultrasound and x-ray abdomen. Exploration after adequate resuscitation was planned. However, an unusual finding of intestinal perforation due to date seed was found.

Entrapment of omentum appears to be the most common cause of obstructed UHs. Incarceration due to foreign body is rarely observed in umbilical hernias. This case highlights the importance of considering unusual etiologies in medical practice.

There is relative lack of data regarding management options for obstructed umbilical hernia and this case is an effort to enrich current literature. Parental education plays a pivotal role in dealing with anxiety as well as executing proper management plan.