Umbilical hernia in children

Case history

A 6-month-old healthy girl presents with a bulge at her umbilicus that her parents have noticed since birth. She has no accompanying symptoms and has been growing and developing normally. Physical exam of the abdomen reveals a soft, nontender bulge at the umbilicus that is easily reduced into the peritoneal cavity with gentle pressure. Reduction allows palpation of the abdominal fascia, revealing an 8 mm fascial defect.