Uncommon Complication of Paediatric Umbilical Hernia: Spontaneous Evisceration. Case Report and Literature Review

A 3 years old girl came to the department of pediatric surgery at Armand Trousseau Hospital with a ruptured umbilical hernia. This child was born prematurely at 27 weeks of gestation. She was handled and treated for persisting arterial duct by a medical prescription of Ibuprofen with uneventful follow-up. She was known carrying a medullar malformation (syringomyelia between the 5th cervical and the 7th thoracic vertebrae) without any neurological impact. Few days before the accident, the patient had progressive constipation. Rupture of the umbilical hernia occurred in our case during a defecation effort. The skin over the hernia broke open, exposing the tissue inside the hernia sac. The infant was transferred to our institution by a medically assisted transfer. The delay between the occurring of the evisceration and the arrival to the hospital was three hours. Clinically the patient was stable except for the ruptured umbilical hernia with eviscerated ommentum. No signs of infection or necrosis were noted. The infant was managed with intravenous fluid, analgesics, and antibiotics.