Case Reports in Pediatrics

Case Report

Omentum in the Pediatric Umbilical Hernia: Is It a Potential Alarm for the Appearance of Complications?

Table 1

Reported cases and sac contents of incarcerated umbilical hernias in children.
AuthorReported complications of umbilical herniasContents of the umbilical hernia sac
Keshtgar and Griffiths [1]7 cases with incarceration:
3 reduced without operation
2 of them with recurrent incarceration
2 of the cases were urgently operated		4 cases operated:
3 cases with small intestine
1 case with irreducible necrotic omentum
Papagrigoriadis et al. [2]3 cases with incarcerationSmall intestine (2)
Small intestine and omentum (1)
Zendejas et al. [3]34 cases, 7% of total umbilical hernias:
Recurrent incarceration 22
Enteric fistula 7
Strangulation 4
Evisceration 1		Not specified
Ameh et al. [4, 15]30 cases, 64% of total umbilical hernias:
Acute incarceration 15
Recurrent incarceration 10
Evisceration 5		Specified only cases with gangrene:
Intestinal gangrene (2)
Omental gangrene (1)
Okada et al. [9]1 reported case with strangulation
Reviewed 38 cases with incarceration or strangulation		Terminal ileum, cecum, appendix
Specified in the review: 34
Small intestine (20)
Omentum (6)
Terminal ileum and cecum (3)
Transverse colon (3)
Greater omentum and small intestine (2)
Fall et al. [11]41 cases, 15% of total umbilical hernias
Strangulation		Small intestine (27, 67%)
Omentum (5, 12%)
Small intestine, cecum, appendix (4, 9%)
Nonidentified (5, 12%)
Vrsansky and Bourdelat [13, 16]4 incarceration cases3 with small intestine
1 with necrotic omentum
Chirdan et al. [17]23 cases of incarceration, 44, 2% of total
umbilical hernias:
15 with acute incarceration
6 with recurrent incarceration
In 2 cases, parents declined surgery after reduction		1 case with gangrenous bowel with
Meckel’s diverticulum
Brown et al. [18]28 cases with incarceration (7, 21% of all umbilical hernias repaired)
9 cases operated because of failed reduction of the content:
6 with omentum (2 necrotic)
3 with small bowel
Komlats et al. [19]1 case of strangulationGangrenous Meckel’s diverticulum