In this form of hernia the size of
the sac is sometimes enormous, the accompanying illustration
showing extreme cases of both scrotal and labial hernia.
Umbilical hernia may be classed under three heads: congenital,
infantile, and adult. Congenital umbilical hernia occurs most
frequently in children, and is brought about by the failure of
the abdominal walls to close. When of large size it may contain
not only the intestines, but various other organs, such as the
spleen, liver, etc. In some monsters all the abdominal contents
are contained in the hernia. Infantile umbilical hernia is
common, and appears after the separation of the umbilical cord;
it is caused by the yielding of the cicatrix in this situation.
It never reaches a large size, and shows a tendency to
spontaneous cure. Adult umbilical hernia rarely commences in
infancy. It is most commonly seen in persons with pendulous
bellies, and is sometimes of enormous size, in addition to the
ordinary abdominal contents, containing even the stomach and
uterus. A few years since there was a man in Philadelphia past
middle age, the victim of adult umbilical hernia so pendulous
that while walking he had to support it with his arms and hands.
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