Umbilical and paraumbilical hernia
Umbilical hernia
These can present either in babies (infantile) or in adults (acquired).
The infantile ones are more common in Afro-Caribbean babies (90% will have one compared to 10% of Caucasian babies) and tend to close themselves by the age of 2 years in over 90% of cases. The belly-button sticks out because of the underlying hernia. They stick out more when the baby cries but usually cause no problems. Repair is only required if the hernia persists beyond 2 years of age.
Paraumbilical hernia
The adult (acquired) one is usually next to the belly-button and is called a paraumbilical hernia. They occur more commonly above the belly-button. They occur when the abdominal wall is stretched because of obesity, pregnancy and other uncommon conditions. The patients tend to be over 35 years old and women are affected 5 times as much as men. The defect in the linea alba (see epigastric hernia section for anatomy) tends to be small and therefore these hernias are more likely to be painful and to strangulate.
