A 2-year-old boy has an asymptomatic reducible umbilical hernia with a fascial defect measuring 0.8 cm. The parents seek repair. The appropriate advice is:

• A Repair now, because strangulation risk rises sharply after 1 year of age
• B Strapping the hernia with adhesive tape to encourage closure
• C Observation, as most defects under 1.5 cm close spontaneously by 4 to 5 years of age ✓
• D Repair only if the child becomes symptomatic, regardless of age

Explanation

Most umbilical hernias in infants close spontaneously as the rectus muscles develop, and defects smaller than 1.5 cm almost always close by 4 to 5 years of age. Strangulation is rare in childhood, so asymptomatic hernias are observed until school entry. Strapping is ineffective and causes skin complications. Repair is advised for defects persisting beyond 4 to 5 years, defects larger than 1.5 to 2 cm, or those enlarging after 2 years.

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.