Umbilical Hernia

Types:

1. Complete or incomplete (depending on whether sac extends through defect or not.)
   
2. Irreducible (incarcerated)
   
3. Sliding (wall of hernia sac not completely formed by peritoneum)
   
4. Richter's hernia (1 side of bowel wall trapped)
   

Causes:

1. Definite familial incidence.
   
2. Prematurity
   
3. Incomplete development of: lateral umbilical ligaments (obliterated umbilical arteries), urachus, round ligament (umbilical vein), subumbilical extension of transversalis fascia (Richet umbilical fascia).
   
4. Increased intra-abdominal pressure.
   

This condition is rarely symptomatic.

Treatment:

Surgery is the treatment of choice.

Indications:

1. Incarceration
2. Symptoms clearly referable to hernia.
3. Large sac

2 types of surgeries may be performed

1. Simple transverse repair of fascial defect.
   
2. Mesh or plug repair.