Incarceration of umbilical hernia in children: is the trend increasing?

Umbilical hernias are common in infants and young children. The natural history of umbilical hernia is spontaneous closure, usually in the first 3 years of life. Complications of incarceration or strangulation of an umbilical hernia are believed to be rare. Therefore, an expectant policy of non-operative management until at least 5 years of age has been considered acceptable. We have managed seven children with complications of umbilical hernia in the past three years. We have reviewed the epidemiological changes in the incidence of abdominal wall defects in children and postulated a possible relationship to the increasing trend of incarceration of umbilical hernias.