WOFAPS 2025 8th World Congress of Pediatric Surgery

Mohamed Helali ¹, Maher yousef ², Mohamed Ibrahim ³

¹ Dongola specialized hospital
² King Salman Hospital
³ National Ribat University Hospital

Introduction:

Umbilical hernia is common in children, with most resolving spontaneously. Complications like rupture and evisceration are very rare but life-threatening. We present this case of spontaneous rupture in a 5-month-old infant to highlight risk factors and management challenges.

Case Presentation:

A 4-month-old female with congenital nephrotic syndrome came with a ruptured umbilical hernia and small bowel evisceration. She had a history of delayed umbilical ring closure and recurrent abdominal distension. On admission, she was tachycardic, febrile, and dehydrated, with exposed bowel. Laboratory findings revealed leukocytosis (WBC 23.1 ×10⁹/L), anemia (Hgb 6.8 g/dL), and hypokalemia (K⁺ 2.5 mmol/L). Because of her critical condition, as well as the lack of some general anesthetic medications due to war surgical reduction was performed under local anesthesia. The bowel was viable and manually reduced, followed by single-layer skin closure. Postoperative recovery was uneventful.

Conclusion:

This case emphasizes the importance of early intervention in high-risk umbilical hernias (big defects, thin/ulcerated skin, comorbidities). Physicians should counsel caregivers on warning signs like (skin discoloration, sudden enlargement) to prevent rupture. Urgent surgical repair remains the cornerstone of management.

Conflict of Interest:

The authors declare no conflict of interest.