7. Size Matters: Understanding the Scale of the Hernia
When we talk about umbilical hernias, the size of the protrusion isn’t a trivial matter. People often assume that a small hernia is a “minor” issue and a larger one is “major.” While intuitive, this line of thinking misses some nuances. The size of the hernia not only impacts how it’s managed but also its likelihood to lead to complications. So, let’s break it down—size does matter, but not always in the ways you might think.
First off, small hernias are generally less than one centimeter in diameter. Due to their diminutive size, they may not even be visible. That doesn’t mean they’re harmless, though. Small hernias can be deceiving; they sometimes carry a higher risk of strangulation, a condition where the blood supply to the protruded tissue gets cut off. The irony? The smaller the opening, the higher the risk.
Medium-sized hernias, often between one and four centimeters, are generally the ones most people notice and get checked out. These are usually easier to detect due to their visibility or the discomfort they cause. Interestingly, these mid-sized hernias often remain stable; they neither self-resolve nor exacerbate rapidly. So, the middle of the road can sometimes be the safest, at least in terms of immediate complications.
Then there are the large hernias, sometimes exceeding four or five centimeters. These big ones usually don’t pose the same risk of strangulation as the small ones, simply because the opening in the abdominal wall is wide enough to reduce that risk. However, their size makes them prone to other issues, such as skin irritation or even infection, due to the larger area they affect. (7)
