In Africa, many of the young children are running around with umbilical hernias (small defects in the abdominal wall at the belly button – AKA a big “outie”). Some protrude only a centimeter while others are considerably larger.
Last week in clinic, Dr. Fort called Jessica and me into his examination room to examine an umbilical hernia on a young woman. I had never seen a hernia so large. It appeared as though the patient had a small watermelon covered in skin attached to the abdomen at the umbilicus. I examined the abdomen. At the top, I felt the bowels moving (peristalsis), but towards the bottom, there was a hard mass. It was not one distinct mass…and it moved. But the movements were not peristalsis…they were fetal movements. She was pregnant and likely 20 weeks along.
The question now is this: how is that umbilical hernia sac going to support a full term pregnancy? Fortunately, this lady lives in town and we can keep a close watch on her pregnancy.
**UPDATE** October 20, 2007 – The woman came back to clinic this week for a check-up and an ultrasound revealed that she is actually 32 weeks pregnant. She has been admitted and will most likely undergo a caesarean section at the hospital.