What is the diagnosis and treatment for umbilical hernia (protrusion)?

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Last updated: April 10, 2025 • View editorial policy

Differential Diagnosis for Umbilical Protrusion

  • Single most likely diagnosis + Umbilical hernia: This is the most common cause of umbilical protrusion, especially in infants and young children. It occurs when part of the intestine or other tissue bulges through an opening in the abdominal muscles near the navel.
  • Other Likely diagnoses + Omphalocele: A congenital anomaly where the intestines or other organs protrude through the navel due to a defect in the development of the abdominal wall. + Umbilical granuloma: A small, benign growth that can occur at the base of the umbilical stump, causing a protrusion.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.) + Incarcerated or strangulated umbilical hernia: Although less common, if a hernia becomes incarcerated (trapped) or strangulated (cut off from blood supply), it can lead to severe complications, including tissue death and peritonitis. + Ruptured omphalocele: If an omphalocele ruptures, it can expose the intestines to the environment, leading to infection and potentially life-threatening complications.
  • Rare diagnoses + Desmoid tumor: A rare, benign tumor that can occur in the abdominal wall, potentially causing an umbilical protrusion. + Urachal cyst or sinus: A congenital anomaly where a cyst or sinus forms along the urachus (a remnant of the allantois), which can cause an umbilical protrusion if it becomes infected or ruptures. + Metastatic disease: In rare cases, a metastatic tumor can cause an umbilical protrusion, known as a Sister Mary Joseph nodule, which is often associated with intra-abdominal malignancies.

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