umbilical hernia

Management:

- <0.5cm: Watchful observation if asymptomatic (hernia usually obliterate)

- Children often have spontaneous closure by age 5. 

- Refer pt to general surgeon if >0.5cm 

- Pt to self-refer to ER if signs of incarceration or strangulation (acute abd. pain, fever, bloody bowel movement).

Strangulation: 

A rare and serious complication related to umbilical hernias in adults is called strangulation. Strangulation is when the blood flow to certain parts of the body is cut off because the hernia causes tissue to bulge. Symptoms of strangulation include nausea, vomiting, and severe pain. The area around the umbilical hernia might look blue, as if you have a bruise. If it does look like this, call a doctor or healthcare professional right away

- Surgery: mesh/plug for adults - 11% recurrence; open excision & closure with suture in peds - high resolution results unless big defects or older than 5 y/o. 

See more:
http://www.healthline.com/health/umbilical-hernia-repair#Overview1
https://www.facs.org/~/media/files/education/patient%20ed/adultumbilical.ashx
http://herryyudha.blogspot.com/2012/02/types-of-hernia-and-management.html