What is the pathophysiology of an abdominal umbilical hernia?

Updated: Jul 23, 2019
  • Author: Assar A Rather, MBBS, MD, FACS; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

An umbilical hernia occurs through the umbilical fibromuscular ring, which is usually obliterated by age 2 years. (See the image below.) They are congenital in origin and are repaired if they persist in children older than 2-4 years. [5, 4]

Hernia of umbilical cord. Hernia of umbilical cord.

Although umbilical hernias in children arise from failed closure of the umbilical ring, only one in 10 adults with umbilical hernias had this defect as a child. Adult umbilical hernias occur through a canal bordered anteriorly by the linea alba, posteriorly by the umbilical fascia, and laterally by the rectus sheath. Proof that umbilical hernias persist from childhood to present in adulthood is only hinted at by an increased incidence among black Americans. Multiparity, increased abdominal pressure, and a single midline decussation are associated with umbilical hernias.


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