A literature review of spontaneous evisceration in paediatric umbilical hernias

Abstract

Umbilical hernias occur frequently in children but complications are very rare and thus surgery is not routinely indicated. In this literature review, we report 19 cases of spontaneous evisceration of abdominal contents through umbilical hernias. Precipitating causes included umbilical ulceration or sepsis, crying, respiratory infection, intussusception and ascites. Management involved resuscitation and surgical repair. Mortality is low. As the incidence of spontaneous rupture is very low, the current management of an umbilical hernia remains appropriate. However, we encourage physicians to be aware of the potential risk factors for spontaneous rupture and in these patients expedite surgical repair.

Ruptura de saco herniario umbilical con evisceración por colocación de cuerpo extraño. Reporte de caso

“…Las hernias umbilicales son más evidentes durante los episodios de llanto, esfuerzo y defecación; pueden generar una protrusión considerable del saco y su contenido. 8 La ruptura espontánea de una hernia umbilical en niños es extremadamente rara y ocurre, sobre todo, en pacientes cirróticos, desnutridos o sépticos. Las hernias grandes son más propensas a la ruptura espontánea: la piel se estira y luce brillante.…”

“…En ambos casos la atención fue tardía. 4,8 La ruptura espontánea de la hernia umbilical suele suceder en el trascurso de la primera infancia. En el momento de la ruptura la paciente tenía dos meses de edad y desnutrición leve.…”

Rupture of Umbilical Hernia with Evisceration in a Newborn - A Case Report

“…The process of closure of the defect is hastened by the recti coming closer when the infant stands erect. Spontaneous rupture is a rarity and needs emergency closure of the defect [3]. Precipitating causes for spontaneous rupture and evisceration include umbilical sepsis, abdominal distension, respiratory distress [3], ventilatory support [2], ascites [4] and rarely Hurlers syndrome [5].…”

Application of an Acellular Dermal Matrix Patch in Infant and Neonatal Abdominal Wall Reconstruction

“…Omphalocoele is an anterior abdominal wall defect covered by an outside cyst membrane through which the abdominal content is pushed out and the umbilical cord enters the cyst membrane. This disease has an incidence of about 1/3000-1/10 000 in surviving newborns (1) and occurs more in males than females (3:2). The specific aetiology of omphalocoele is unknown, but it is generally believed that the defect occurs in the third-week of pregnancy and is caused by embryonic coelom closure occurring prematurely.…”