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Difference in Umbilical Hernia and Omphalocele

Posted

What is the difference between these two?

The way I see it, a UH is something that occurs gradually, after birth. An omphalocele, on the other hand, is already present at birth, before the umbilical cord is even cut off. Do you agree?

Oh, and FYI: Please don't simply cut-and-paste some random dictionary quote. I do appreciate those, but the reason I even post questions here in the first place, like a lot of people, is because I've already checked out my books and dictionaries, and I'm still confused. I don't mind if you want to include a quote or website, but I'm also interested in a personal interpretation of whatever definition you want to quote.

vashtee, RN

Specializes in DOU.

As I (a student) understand it, an omphalocele is a type of hernia. The difference is that it needs to be treated surgically, whereas an umbilical hernia often does not require treatment at all.

prmenrs, RN

Specializes in NICU, Infection Control. Has 42 years experience.

An omphalocele is an [usually large] abdominal wall defect; it is a surgical emergency, and the baby usually goes to the OR w/in the 1st 24 hrs of life. It is not covered w/skin.

An umbilical hernia may present itself @ birth, but you're more likely to see it later in infancy, childhood, or (if female) not even til pregnancy--it's actually sort of an umbilical rupture then. Skin does cover the defect, and it is no where near as large as an omphalocele.

An omphalocele is an abdominal wall defect that includes the umbilicus--you can't even tell which part is the umbi w/o a thorough exam, a gastroschisis is an abdominal wall defect that is similar, but the umbilicus is not included, and can easily be identified.

How's that? :monkeydance:

prmenrs, RN

Specializes in NICU, Infection Control. Has 42 years experience.

And here's an umbilical hernia:

UmbiliHerniaff.jpg

2bDoc_J1977

Specializes in emergency, urgent care, trauma.

Posting to a 2 year old thread...wonder if any one needs the answer still.

Normally in fetal development, the midgut (last 1/2 duodenum all the way to the 2/3 transverse colon) protrudes out through the umbilical cord. This allows the midgut to grow, rotate, develop, etc...Protrusion out the umbilical cord happens about week 6 in development. At about week 10, the contents should begin returning to inside the body (out of the umbilical cord).

When the intestines do not return from the umbilical cord, this is what causes an Omphalocele. The omphalocele will not have skin on top of it, only the umbilical membrane.

An umbilical herniation is a weakening of the muscles/fascia around the umbilicus and protrudes tissue/organs through that area. Skin will be covering the herniation.

ok, well i'm still confused. i'm a 28 y.o. female who has been experiencing a constant throb in my belly button. i went to the emergency room today, and the doctor told me i have an omphalocele, and that i've always had it, and that it appears to be infected. i have a very deep belly button and when you look in there, it looks like a healthy, pink, pencil eraser size protrusion. it hurts to the touch. how is this not an umbilical hernia, but an omphalocele??? there is absolutely nothing on omphalocele's in adulthood, and considering it's size...i'm more confused than ever! if anyone could clarify i would be greatful, but if not, i'll update what the surgeon says, once i see him, as i was referred to a surgeon today...does that mean i need surgery? i'm on antibiotics and pain medication because of this. ~scared and confused...:confused:

Edited by Silverdragon102
resized to make easier reading

Silverdragon102, BSN

Specializes in Medical and general practice now LTC. Has 33 years experience.

ok, well i'm still confused. i'm a 28 y.o. female who has been experiencing a constant throb in my belly button. i went to the emergency room today, and the doctor told me i have an omphalocele, and that i've always had it, and that it appears to be infected. i have a very deep belly button and when you look in there, it looks like a healthy, pink, pencil eraser size protrusion. it hurts to the touch. how is this not an umbilical hernia, but an omphalocele??? there is absolutely nothing on omphalocele's in adulthood, and considering it's size...i'm more confused than ever! if anyone could clarify i would be greatful, but if not, i'll update what the surgeon says, once i see him, as i was referred to a surgeon today...does that mean i need surgery? i'm on antibiotics and pain medication because of this. ~scared and confused...:confused:

hi and welcome to the site

as per terms of service we can not offer medical advice, the best one to talk to is the surgeon when you see them

2bDoc_J1977

Specializes in emergency, urgent care, trauma.

Hey younger LPN,

Best thing, obviously, is to have the doctor explain it to you. I will try and help you along, but sometimes words alone are unhelpful. I am not giving you any treatment advice, since that is not what you are asking for. you seem to just want to have clarification of what different disorders in order to further educate yourself. i should be fine in posting a reply.

973235-975583-75.jpg

The above picture is an omphalocele. During development, the GI tract goes out into the unmilical cord in order complete the elongfation, twisting, and other developmental processes that are required when we are growing in our mother's stomach. What you see is the abdominal contents still present in the umbilical cord. That part of the body, the umbilicul, never fully closed. Do you notice that is is surrounded by a membrane, the umbilical cord? now, this may be a little large, but it is not massive by any means.

extrophy-of-bladder-epispad.jpg

This here is an example of exstrophy. This occurs when our body does not form properly as well. Our bodies start off as a flat disc. (I am going to skip a whole bunch of steps here to get to the main point). our bodies need to bend and fold in order to make a cyliner that is able to sustain life and allow for room of our internal organs to grow, etc... (again, this is horribly simplified.) Take a flat peice of paper, then roll it so that the ends touch each other. now you have a cylinder. in extrophy, the ends did not meet and did not fuse. notice the abdominal contents are outside of teh umbilical tube? The problem here was NOT that the GI tract went onto the body from the umbilical cord, rather it was that the body did not meet in the middle and fuse properly.

UmbilicalHernia.jpg

Finally, the hernia. first you will notice that there is skin around it, not a membrane like the first picture. you will also notice that everything seemed to be developed right, but for some reason there is a protrusion coming from the abdominal area. So, the body folded correctly, the GI tract developed appropriately, and then the contents went back into the body like they were supposed to. So, what went wrong? The FASCIA. This is one of the hardest concepts to understand! The fascia is a fibrous layer that is strong and will help hold different structures in their body compartments in place, so they are not just moving around. For some reason, the fascia that is present at that area has weakened and have allowed the GI contents to begin bulging out of the body. if you were to take a balloon and blow it up half way, the balloon would be round and all the "membrane" is the same thickness. If you squeeze that balloon, one area of the balloon "bulges out" and that membrane in noticeably thinner than the rest of the balloon's membrane. Is a sense, due to and increase in pressure (or loss of integrity of the membrane), the bulge is able to occur. this is the hernia.

I know this is wordy. I hope this has helped you.

Edited by 2bDoc_J1977
Was answering the wrong person's post.

thank you for your reply! yes, you were very helpful! you got my name wrong though ~ lol. so what did they end up doing with my omphalocele? did they push my abdominal contents back into my body and tie the umbilical cord? what, then, is trying to make it's way out of my belly button? i'm calling to make an appointment with the surgeon tomorrow...do you think surgery is necessary? obivously i know you don't know the exact details, but if i've never dealt with this before now...you'd think i'd be ok once i finish the antibiotics...???

2bDoc_J1977

Specializes in emergency, urgent care, trauma.

YooperLPN (got your name right this time...:),

maybe you could ask your mother/father if you had something when you were born? in all of my training, as a combat medic, a nurse, and now a medical student, i can tell you I have never seen this ever (i run away from neonates, infants, and toddlers). Therefore, I do not know what they might have done and why they wouldn't have corrected it earleir if it was an ophalocele. i just find it odd that now you have a presenting omphalocele at this age in life, with no prior complications associated with it.

I would be very interested in knowing what the surgeon says. If you could update us, that would be good.

Antibiotics, pain meds...those are all band-aids to a structural problem. Surgery, in some way, is usually the answer to fixing these things. At 28 y/o, I wonder if you have children. if yes, I wonder why you may not have noticed it before.

Good luck.

Edited by tnbutterfly

i asked my mom & dad and they said that nothing was ever told to them about any issue, problem, etc. i do not have any children, never have. that's why i'm so confused! i guess i'll just wait and see what the surgeon says and keep you posted! thanks for all your help...i greatly appreciate it! and thank you for getting my name right this time! :w00t:

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