At a glance: Central umbilical hernia vs paraumbilical hernia

Paraumbilical hernia is more common in adults than children
Paraumbilical hernia is more common in adults than children

Central umbilical hernia
Clinical features

  • Occurs following failed fusion of the anterior abdominal wall after birth.
  • Often evident a few days after delivery.
  • The hernias are usually small.
  • The underlying defect is usually smaller than the visible hernia.
  • A cough reflex is present. 


  • Most settle spontaneously and parents can be reassured.
  • Surgeons are usually unhappy to operate before one year old.
  • Strangulation never occurs in central hernias.

Paraumbilical hernia
Clinical features

  • Occur as a central swelling usually above or below the umbilicus.
  • These hernias may become very large.
  • More common in adults (especially women), than children.
  • May be associated with obesity and weak abdominal muscles.
  • The sac may contain both bowel and omentum.
  • This is a true defect in the linea alba close to the umbilicus. 


  • These hernias will not resolve without surgical intervention.
  • The patient should be advised to lose weight.
  • Surgical repair is recommended because of strangulation risk. 

Contributed by Dr Nigel Stollery, a GP in Kibworth, Leicestershire and a clinical assistant in dermatology at Leicester Royal Infirmary

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Before commenting please read our rules for commenting on articles.

If you see a comment you find offensive, you can flag it as inappropriate. In the top right-hand corner of an individual comment, you will see 'flag as inappropriate'. Clicking this prompts us to review the comment. For further information see our rules for commenting on articles.

comments powered by Disqus