From the Guidelines
Umbilical retraction, also known as navel pulling, is not a widely recognized medical term, but it can be associated with umbilical hernia, which is a condition where part of the intestine or other tissue bulges through an opening in the abdominal wall near the navel. The management of umbilical hernia is crucial, especially in patients with ascites, as it can lead to complications such as ulceration, incarceration, strangulation, and rupture 1. In terms of treatment, surgical repair of umbilical hernia should be considered in discussion with the patient and a multidisciplinary team involving physicians, surgeons, and anesthetists 1. Some key points to consider in the management of umbilical hernia include:
- The incidence of abdominal wall hernia in cirrhotic patients is 16% and reaches 24% in the presence of ascites, with more than half being umbilical hernias 1
- Non-operative management of complicated hernias can result in high mortality rates, ranging from 60-88% 1
- Hernia repair in cirrhosis can be associated with high postoperative morbidity and mortality, especially in emergency situations or in patients with advanced liver disease 1
- Optimizing management of ascites, including large volume paracentesis (LVP) and transjugular intrahepatic portosystemic shunt (TIPSS) perioperatively, can reduce the risk of wound dehiscence and recurrence of hernia 1
From the Research
Definition and Explanation
- Umbilical retraction, also known as navel pulling, is not directly defined in the provided studies 2, 3, 4, 5, 6.
- However, the studies discuss umbilical hernias, which may be related to the concept of umbilical retraction.
- Umbilical hernias occur when part of the intestine or other tissue bulges through an opening in the abdominal wall near the navel 2, 3, 4, 5, 6.
Related Concepts
- Umbilical hernia repair is a common surgical procedure, and various approaches are discussed in the studies, including open, laparoscopic, and robotic options 2, 3, 4, 5, 6.
- The use of mesh reinforcement is recommended to decrease recurrence rates, even in small hernias 2, 3, 4, 5, 6.
- Complications such as large seromas, surgical site infection, and recurrence are discussed in the studies 2, 3, 4, 5, 6.
Key Findings
- The studies emphasize the importance of tailored treatment options for umbilical hernias, taking into account the size of the hernia and the patient's overall health 2, 3, 4, 5, 6.
- Mesh implantation is recommended for larger and borderline-sized hernias to reduce the risk of recurrence 5.
- The choice of surgical method depends on the size of the hernial sac and fascial defect, as well as the patient's individual characteristics 5, 6.