Clinical analysis of umbilical hernia in adults treated surgically – Emergency ppoperation cases of incarcerated umbilical hernia – *
Adult umbilical hernia is a relatively rare disease in Japan, but the rate of occurrence has been increasing as dietary habits continue to shift toward Western styles. We performed surgery in a total of 13 cases of umbilical hernia during the 11-year period from 1997 to 2007, and we herein present our findings of those cases. The subjects were 2 males and 11 females, ranging in age from 28 to 78 years old. Twelve of these cases presented with obesity, a pre-existing illness, or a complication that may lead to an increase in abdominal pressure such as ascites due to cirrhosis after delivery, or peritoneal dialysis for renal failure. Incarceration was present in eight cases, and the remaining five cases were non-incarcerated. Eleven cases were closed using sutures, one case involved the use of a Kugel patch, and one case underwent an enterectomy and colostomy. In terms of postoperative complications, there was one case of wound infection, one case of necrosis of the skin, and one case of severe obesity in which the incarcerated intestinal tract exhibited avascular necrosis and postoperative septicemia, with respiratory failure and a subcutaneous abscess also being observed. Compared to the non-incarcerated cases, those with an incarcerated umbilical hernia more often had underlying illnesses and higher occurrences of postoperative complications. However, among the five cases in which hernia incarceration could not be eliminated and an emergency operation was required, four of them who underwent surgery within 20 hours did not require an enterectomy and did not experience any postoperative complications. We believe that it is important to treat an incarceration of an umbilical hernia as early as possible to avoid postoperative complications. (Accepted on April 18，2008)
