Management

All hernias in adults should be repaired unless the patient's condition would result in an unacceptably high mortality. Support with trusses or surgical belts may be appropriate conservative management in the very high-risk patient.

Umbilical hernias in infants are very common. Umbilical hernias in adults, children over 4 years of age and large (>2 cm) umbilical hernias in children less than 4 years of age should be repaired.

An area of some controversy is the exploration of the contralateral groin in children with inguinal hernias. Presence of a hernia on the contralateral side may be as high as 50-75% in select groups of these patients. Most pediatric surgeons do explore the contralateral groin in boys under 2 years of age and girls under 4.

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