title: Profile of paediatric umbilical hernias managed at Federal Medical Centre Umuahia.
abstract: BACKGROUND
  Umbilical hernias are common in children but many resolve spontaneously within the first five years of life. Most umbilical herniorrhaphies in our environment are due to symptomatic hernias which constitute a small percentage of all umbilical hernias.
  
  
  METHODS
  A retrospective review of all pediatric patients with UH treated at Federal Medical Centre Umuahia, Abia State from February 2001 to February 2011.
  
  
  RESULTS
  There were 22 patients but only 20 of the folders were found and analyzed. They were made up of 11 males and 9 females with a mean age of 6.19 +/- 0.83 years and median age of 6 years. Nine(7 males and 2 females) had acute incarcerations, nine (3 males and 6 females) had recurrent umbilical pains without incarceration and two (1 male and 1 female) had recurrent incarcerations. Age range for acute incarceration was 2-8 years (mean: 4.69 years, median: 4 years); recurrent umbilical pains was 4 months -15 years (mean: 7.7 years, median: 8 years) and for recurrent incarceration 2-10 years (mean: 6 years). All had standard umbilical hernia repairs except one whose parents declined surgery after reduction of acute incarceration. One patient with acute incarceration had gangrenous bowel with hernia sac abscess and was offered bowel resection with end-to-end anastomosis. On short-term follow-up, the symptoms resolved in all the patients following surgery. Five patients had six complications: 1 exuberant granulation tissue, 2 stitch reactions, 2 superficial wound dehiscence and one superficial wound infection. There were no mortalities and no recurrence on short-term follow-up. Only one patient (5%) registered under the National Health Insurance Scheme (NHIS).
  
  
  CONCLUSIONS
  Active observation of all umbilical hernias at all ages will ensure early detection of complications and prompt treatment. Elective repair of umbilical hernias in patientsabove five years with fascia defect greater than 1.5cm is encouraged. Comprehensive NHIS will ensure early presentation and reduced complications.
authors.affiliation: Pediatric Surgery Unit, Department of Surgery, Federal Medical Centre Umuahia, Abia State, Nigeria. ezomikeuche@yahoo.com
authors.forename: U O
authors.initials: UO
authors.lastname: Ezomike
authors.forename: M A
authors.initials: MA
authors.lastname: Ituen
authors.forename: S C
authors.initials: SC
authors.lastname: Ekpemo
authors.forename: C B
authors.initials: CB
authors.lastname: Eke
authors.forename: B C
authors.initials: BC
authors.lastname: Eke
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006554:Hernia, Umbilical / Q000150:complications* / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects; D006801:Humans; D008297:Male; D009549:Nigeria; D012189:Retrospective Studies