Umbilical hernia differential diagnosis

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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

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

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: Linea alba through weakened umbilical ring. Paraumbilical hernias through linea alba in the region of the umbilicus.
Epigastric hernia	On physical exam; reducible, visible with valsalva and disappears with laying flat, non- tender.	Location: Linea alba between umbilicus and xiphoid process.
Spigelian hernia	On physical exam; reducible, visible with valsalva and disappears with laying flat, non- tender.	Location: Semilunar line: along the lateral borders of rectus abdominis. Herniation typically occurs caudally (below arcuate line) due to absence of posterior rectus sheath.
Incisional hernia	On physical exam; reducible, visible with valsalva and disappears with laying flat, non- tender.	Location: Site of prior incision.

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]