Umbilical shapes predict future protrusion in pediatric umbilical hernias

Abstract

Background This study was conducted to evaluate the incidence and early predictive factors of the development of protuberant umbilicus in pediatric umbilical hernia patients. Methods In this retrospective visual and chart review, patients younger than 3 months with umbilical hernias who initially visited Ina Central Hospital from April 2011 to March 2017 and were followed until they started to walk (at the age of 1 year) were evaluated. The umbilici of the patients at the age of 1 year were classified into two types based on the appearance: concave and protuberant umbilici. Single‐factor and logistic regression analyses of the association between the appearance of the umbilicus at the age of 1 year and various clinical data were performed. Results Of the 103 patients, 72% had concave umbilici, and 28% had protuberant umbilici. Single‐factor analysis showed significant differences in the umbilical shapes at the initial visit (p < 0.001) and straining habit (p < 0.001). The most ideal logistic regression model demonstrated that umbilici of the highly inflated balloon type (odds ratio, 27.00; 95% confidence interval odds ratio, 5.60‐130.08) and crescent type (odds ratio, 14.34; 95% confidence interval odds ratio, 4.22‐48.77) were more likely to develop into protuberant umbilici. Conclusions Umbilical shapes at the initial visit can be used to predict the future development of protuberant umbilici in pediatric patients with umbilical hernias.