Low risk, but not no risk, of umbilical hernia complications requiring acute surgery in childhood
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- All authors have contributed significantly, and all authors are in agreement with the content of the manuscript.
- The protocol for the research project has been approved by a suitably constituted Ethics Committee at Princess Margaret Hospital, and it conforms to the provisions of the Declaration of Helsinki in 1995 (as revised in Tokyo 2004).
- Conflict of interest: The authors have no financial support or relationships that may pose conflict of interest.
Umbilical hernias are a common finding in the paediatric community, with a preponderance to affect Afro-Caribbean and premature children. The rate of incarceration varies greatly between populations. Therefore, it is valuable to obtain some Australian data on this topic.
We undertook a retrospective study of the records of all patients who underwent umbilical hernia repair over a 12-year period of between October 1999 and May 2012 at Princess Margaret Hospital. From this group, all patients that had an umbilical hernia repair for reason of acute complication were identified and analysed for age, ethnicity and co-morbidities.
Between October 1999 and May 2012, 433 umbilical hernias were repaired at Princess Margaret Hospital, five of which were as the direct result of an acutely complicated umbilical hernia. The mean age of hernia repair was 5 years old, and the mean age of acute complication was 5 years old. Out of the patients with acutely complicated umbilical hernia, there were no Afro-Caribbean patients, and one was premature complicated by hyaline membrane disease and broncho-pulmonary dysplasia.
Western Australia has an incidence of acutely complicated umbilical hernia requiring operative intervention of 1:3000 to 1:11 000. On an international scale, this is low, and studies with similar incidence do not advocate for immediate repair of all identified umbilical hernias. The authors believe repair should be guided by patient and guardian, but if there is an episode of incarceration, acute repair is advised.