Umbilical hernia differential diagnosis: Difference between revisions

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__NOTOC__
__NOTOC__
{{Umbilical hernia}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Umbilical_hernia]]
{{CMG}}; {{AE}} {{HQ}}
{{CMG}}; {{AE}} {{HQ}}


==Overview==
==Overview==
Umbilical hernia must be differentiated from epigastric hernia, Spigelian hernia, and incisional hernia.
Umbilical hernia must be differentiated from [[epigastric hernia]], [[Spigelian hernia]], and [[incisional hernia]].


==Differentiating umbilical hernia from other Diseases==
==Differentiating umbilical hernia from other Diseases==
*Umbilical hernia must be differentiated from epigastric hernia, Spigelian hernia, and incisional hernia.
*Umbilical hernia must be differentiated from [[epigastric hernia]], [[Spigelian hernia]], and [[incisional hernia]].<ref name="urlHernia, Umbilical - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/29083594 |title=Hernia, Umbilical - PubMed - NCBI |format= |work= |accessdate=}}</ref><ref name="urlHernia, Pediatric Umbilical - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/29083740 |title=Hernia, Pediatric Umbilical - PubMed - NCBI |format= |work= |accessdate=}}</ref><ref name="BlayStulberg2017">{{cite journal|last1=Blay|first1=Eddie|last2=Stulberg|first2=Jonah J.|title=Umbilical Hernia|journal=JAMA|volume=317|issue=21|year=2017|pages=2248|issn=0098-7484|doi=10.1001/jama.2017.3982}}</ref>


===Preferred Table===
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align="center"
{|
| valign="top" |
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|
! rowspan="2" |Diseases
|+
! colspan="4" |History and Symptoms
'''Abdominal [[hernias]] differential table based on location'''
! colspan="4" |Physical Examination
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
! colspan="4" |Laboratory Findings
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Similar Features}}
! rowspan="2" |Other Findings
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Finding
1
!Finding 2
!Finding 3
!Finding
4
!Physical Finding 1
!Physical Finding 2
!Physical Finding 3
!Physical Finding 4
!Lab Test 1
!Lab Test 2
!Lab Test 3
!Lab Test 4
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Umbilical Hernia
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="background: #F5F5F5; padding: 5px;" |
* On physical exam; reducible, visible with [[Valsalva maneuver|valsalva]] and disappears with laying flat, non- [[Tenderness (medicine)|tender]].
| style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
| style="padding: 5px 5px; background: #F5F5F5;" |Location:  
| style="background: #F5F5F5; padding: 5px;" |
* [[Linea alba]] through weakened [[umbilical]] ring.
| style="background: #F5F5F5; padding: 5px;" |
* Paraumbilical [[Hernia|hernias]] through [[linea alba]] in the region of the [[Navel|umbilicus]].
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Epigastric hernia]]
| style="background: #F5F5F5; padding: 5px;" |'''↑'''
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="background: #F5F5F5; padding: 5px;" |
* On physical exam; reducible, visible with [[Valsalva maneuver|valsalva]] and disappears with laying flat, non- [[Tenderness (medicine)|tender]].
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5;" |Location:
| style="background: #F5F5F5; padding: 5px;" | -
* [[Linea alba]] between [[Navel|umbilicus]] and [[xiphoid process]].
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Spigelian hernia]]
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="background: #F5F5F5; padding: 5px;" |↓
* On physical exam; reducible, visible with [[Valsalva maneuver|valsalva]] and disappears with laying flat, non- [[Tenderness (medicine)|tender]].
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5;" |Location:
| style="background: #F5F5F5; padding: 5px;" |
* [[Semilunar hiatus|Semilunar]] line: along the lateral borders of [[Rectus abdominis muscle|rectus abdominis]].
| style="background: #F5F5F5; padding: 5px;" |
* [[Hernia|Herniation]] typically occurs [[Anatomical terms of location|caudally]] (below [[arcuate]] line) due to absence of [[Anatomical terms of location|posterior]] [[Rectus abdominis muscle|rectus]] sheath.
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Incisional hernia]]
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="background: #F5F5F5; padding: 5px;" |
* On physical exam; reducible, visible with [[Valsalva maneuver|valsalva]] and disappears with laying flat, non- [[Tenderness (medicine)|tender]].
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5;" |Location:
| style="background: #F5F5F5; padding: 5px;" |
* Site of prior [[incision]].
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|}
|}
Importantly this type of hernia must be distinguished from a para-umbilical hernia which occurs in adults and involves a defect in the midline near to but not through the umbilicus. It is also important to differentiate an umbilical hernia from [[omphalocele]].


{{familytree/start|summary=Sample 1}}
{{familytree/start|summary=Sample 1}}
{{familytree | | | | | | | | A01 |A01=Abdominal Hernias}}  
{{familytree | | | | | | | | A01 |A01=[[Abdominal Hernias]]}}  
{{familytree | | | | |,|-|-|-|^|-|-|-|-|-|-|-|-|-|.| | | }}
{{familytree | | | | |,|-|-|-|^|-|-|-|-|-|-|-|-|-|.| | | }}
{{familytree | | | B01 | | | | | | | | | | | | |B02 | | |B01=Abdominal wall|B02=Groin}}
{{familytree | | | B01 | | | | | | | | | | | | |B02 | | |B01=Abdominal wall|B02=Groin}}
{{familytree | |,|-|^|-|v|-|-|-|v|-|-|-|.| | | | | | | | | }}
{{familytree | |,|-|^|-|v|-|-|-|v|-|-|-|.| | | | | | | | | }}
{{familytree | D01 | | D02 | | D03 | | D04 |D01=Umbilical |D02=Epigastric|D03=Spigelian|D04=Incisional}}
{{familytree | D01 | | D02 | | D03 | | D04 |D01=[[Umbilical]] |D02=[[Epigastric]]|D03=[[Spigelian]]|D04=[[Incisional]]}}
{{familytree/end}}
{{familytree/end}}
[[File:Hernia Common Sites.png|thumb|center|369x369px|Abdominal hernia differential Source:By BruceBlaus (Own work) CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons]]


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Gastroenterology]]
[[Category:Surgery]]
[[Category:Pediatrics]]
[[Category:Up-To-Date]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Gastroenterology]]


{{WS}}
{{WS}}
{{WH}}
{{WH}}

Latest revision as of 20:44, 13 February 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]

Overview

Umbilical hernia must be differentiated from epigastric hernia, Spigelian hernia, and incisional hernia.

Differentiating umbilical hernia from other Diseases

 Abdominal hernias differential table based on location
Differential Diagnosis Similar Features Differentiating Features
Umbilical Hernia
  • On physical exam; reducible, visible with valsalva and disappears with laying flat, non- tender.
 Location:
Epigastric hernia
  • On physical exam; reducible, visible with valsalva and disappears with laying flat, non- tender.
 Location:
Spigelian hernia
  • On physical exam; reducible, visible with valsalva and disappears with laying flat, non- tender.
 Location:
Incisional hernia
  • On physical exam; reducible, visible with valsalva and disappears with laying flat, non- tender.
 Location:
 
 
 
 
 
 
 
Abdominal Hernias
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Abdominal wall
 
 
 
 
 
 
 
 
 
 
 
 
Groin
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Umbilical
 
Epigastric
 
Spigelian
 
Incisional
Abdominal hernia differential Source:By BruceBlaus (Own work) CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons

References

  1. ↑ "Hernia, Umbilical - PubMed - NCBI".
  2. ↑ "Hernia, Pediatric Umbilical - PubMed - NCBI".
  3. ↑ Blay, Eddie; Stulberg, Jonah J. (2017). "Umbilical Hernia". JAMA. 317 (21): 2248. doi:10.1001/jama.2017.3982. ISSN 0098-7484.

Template:WS Template:WH

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