Bulging in the abdomen above the belly button - Hernia after a C-section?
May 3, 2011 | 15,00 EUR | answered by Dr. med. Ralf Berg
Dear Dr.,
7 months ago, I unfortunately had a secondary CESAREAN section.
Regarding my issue:
Now, 2 months after the CS, I felt a strange phenomenon when I touched my stomach above the navel (under the abdominal wall) - a movable knot/lump that disappears when I press on it, but then reappears after some time. I noticed that after having a bowel movement, the upper abdomen bulges slightly and the lump does too, causing discomfort and slight shortness of breath. I have also been suffering from chronic constipation for many years. I looked up on the internet and was alarmed when I came across the topic of "epigastric hernia" or "umbilical hernia", although I am not sure if hypochondria is also at play. Additionally, I have a small dent right above my belly button, where I feel this strange knot. It is sometimes there and sometimes not inside my abdomen, but I cannot see it from the outside.
I must mention that I never did any postnatal exercises due to my poor mental state after giving birth. Could there be a connection?
I am afraid of having a hernia and needing another surgery. Based on my descriptions and the picture provided, how likely do you estimate it is that I have a hernia (also in percentage terms)?
I also have the following question:
1. If I acquired the hernia during pregnancy, why wasn't it detected and repaired during the cesarean section? Shouldn't the doctor have seen it when performing the surgery?
After the CS, my belly button looks like a "cherry pit" protruding out!
Thank you for any helpful advice.
Thank you!
Dear questioner,
first of all, congratulations on the birth of your child.
Based on your descriptions and the picture, it does indeed seem like you have a umbilical hernia. However, you should not blame yourself for the regression in your gymnastics, as it cannot prevent hernias, as far as I know. It is simply nature of pregnancy that the tissue needs to stretch significantly, which can lead to breaks at weak points. Regarding your questions: With a cesarean section, the main focus is on the gentle, quick, and safe delivery of the child. This includes keeping the anesthesia as short as possible. No further examinations are carried out. (Most mothers want to breastfeed afterwards). A hernia is not visible during the procedure, as the entire body, except for the incision area, is covered with sterile cloths. And the incision for the cesarean section is significantly lower. As you have mentioned, you only noticed the "cherry pit" after the C-section. Often, the hernia openings are not visible or palpable while the child is still in the womb and everything is under tension. Even though you may understandably not want another surgery, I still advise you to consult a surgeon about your umbilical hernia. The fact that you sometimes feel a knot and then not, suggests that at times, intestines or mesh components are lodged in your abdominal walls. (This is also the reason for your discomfort and shortness of breath.) Since intestines or mesh components can become trapped in a hernia opening, leading to an emergency surgery, despite your discomfort, you should show your findings to a surgeon or your primary care physician, so that this risk can be assessed. There is still hope that the tissue will tighten up a bit in the next 3-4 months and the hernia opening will shrink, but the likelihood of this happening is not very high. As for your question about the likelihood of what you are describing actually being a umbilical hernia, I'm afraid it's more than 95% rather than less. (sorry). However, a umbilical hernia is not really something serious. And it does not need to be operated on immediately. But due to the risk of incarceration, one should consider, without bias, consulting an experienced surgeon for an examination, and if they deem the condition "in need of repair," consider that possibility.
With warm regards, Dr. Ralf Berg
