Management of umbilical hernia in children

The management of umbilical hernia in children is based on the natural course of spontaneous resolution in most asymptomatic individuals and a higher recurrence rate if surgical correction is performed before 4 years of age. Refer to the UpToDate topic on umbilical hernia for additional details.

* Incarcerated hernia is defined as inability to reduce hernia by manipulation.
¶ Strangulated hernia is defined as vascular compromise of the contents of an incarcerated hernia.
Δ Underlying conditions in which spontaneous closure is unlikely include: Ehlers-Danlos syndrome, Beckwith-Wiedemann syndrome, Down syndrome, mucopolysaccharidoses, hypothyroidism, and trisomy18.
◊ Behavioral concerns include poor feeding, chronic pulling on the hernia, bullying, and shame.

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Management of umbilical hernia in children