From the Guidelines
A medical assessment for a possible umbilical hernia consists of a thorough physical examination and medical history review, with a focus on evaluating for signs of incarceration or strangulation, as these conditions require immediate surgical intervention to prevent high morbidity and mortality rates 1. The assessment includes:
- A physical examination of the abdomen while the patient is both standing and lying down, looking for a visible bulge near the navel that may increase with coughing or straining
- Palpation of the area to feel for the hernia defect and determine if it's reducible (can be pushed back in)
- Measuring the size of the hernia and the fascial defect
- Checking for tenderness
- Evaluating for possible incarceration or strangulation, using signs such as pain, fever, tachycardia, and leukocytosis, as well as laboratory tests like lactate and D-dimer levels 1
- Medical history questions will focus on when the bulge was first noticed, associated symptoms like pain or discomfort, and risk factors such as pregnancy, obesity, or chronic cough In some cases, imaging studies may be ordered, with ultrasound being the first-line choice for confirmation, especially in obese patients or when the diagnosis is uncertain, and CT scans might be used for complex cases or when complications are suspected 1. The goal of this comprehensive assessment is to determine whether the hernia requires surgical repair or can be managed conservatively with monitoring, and to identify any potential complications early on, in order to improve patient outcomes and reduce morbidity and mortality rates 1.
From the Research
Medical Assessment for Possible Umbilical Hernia
The medical assessment for a possible umbilical hernia consists of several key components, including:
- A thorough physical examination of the abdomen to check for a bulge or swelling near the belly button 2
- A review of the patient's medical history to determine if they have any symptoms such as pain or discomfort in the abdomen 3
- An examination to check for incarceration or strangulation of the hernia, which can be a serious complication 4, 5
- Diagnostic clues to assist in the differential diagnosis, such as understanding the embryologic processes related to the condition 6
Examination Techniques
The examination of the abdomen for a possible umbilical hernia may involve:
- Checking for a bulge or swelling near the belly button 2
- Asking the patient to cough or strain to see if the bulge increases in size 2
- Checking for tenderness or pain in the abdomen 3
- Examining the patient's medical history to determine if they have any underlying conditions that may be contributing to the hernia 3
Management and Treatment
The management and treatment of an umbilical hernia may involve:
- Surgery to repair the hernia, which may be necessary if the hernia is symptomatic or has become incarcerated or strangulated 3, 4, 5
- Non-operative management, such as watching and waiting to see if the hernia resolves on its own, which may be appropriate for small, asymptomatic hernias 4, 6
- Explaining the condition to the patient and providing guidance on management and treatment options 2, 6