A 2-year-old boy has a small umbilical protrusion that increases on crying. The defect measures 0.8 cm and is easily reducible; the child is otherwise well. What is the correct advice to the parents?

• A Immediate surgical repair to prevent strangulation
• B Apply adhesive strapping with a coin over the defect
• C Repair only if the child becomes symptomatic, regardless of age
• D Observe, as most defects close spontaneously by 3 to 5 years of age ✓

Explanation

Infantile umbilical hernias arise from incomplete closure of the umbilical ring and close spontaneously in the vast majority by 3 to 5 years because the recti grow together across the defect. Strangulation is rare in children, unlike adults. Strapping and coin taping are ineffective and cause skin irritation. Repair is advised if the hernia persists beyond 3 to 5 years, the fascial defect exceeds about 1.5 cm, or it enlarges progressively.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.