{"id":165,"date":"2015-08-12T23:36:29","date_gmt":"2015-08-13T02:36:29","guid":{"rendered":"http:\/\/drdouglascaetano.med.br\/web\/?page_id=165"},"modified":"2015-08-13T07:42:14","modified_gmt":"2015-08-13T10:42:14","slug":"hernia-umbilical","status":"publish","type":"page","link":"http:\/\/drdouglascaetano.med.br\/web\/?page_id=165","title":{"rendered":"H\u00e9rnia Umbilical"},"content":{"rendered":"<p><span style=\"color: #808080;\"><strong>H\u00e9rnia Umbilical<\/strong><\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">O que \u00e9?<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">\u00c9 o defeito do fechamento da estrutura fibromuscular do anel umbilical, permitindo a protrus\u00e3o de \u00f3rg\u00e3os intra-abdominal atrav\u00e9s da falha, que pode ser notada como abaulamento da \u00a0 cicatriz umbilical. Geralmente al\u00e7as intestinais.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\"><a style=\"color: #808080;\" href=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-01.png\"><img decoding=\"async\" loading=\"lazy\" class=\" wp-image-166 alignleft\" src=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-01-300x226.png\" alt=\"H\u00e9rnia umbilical 01\" width=\"357\" height=\"269\" srcset=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-01-300x226.png 300w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-01.png 525w\" sizes=\"(max-width: 357px) 100vw, 357px\" \/><\/a><\/span><\/p>\n<p><span style=\"color: #808080;\"><img decoding=\"async\" loading=\"lazy\" class=\"  wp-image-167 alignleft\" src=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-02-221x300.png\" alt=\"H\u00e9rnia umbilical 02\" width=\"186\" height=\"253\" srcset=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-02-221x300.png 221w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-02.png 288w\" sizes=\"(max-width: 186px) 100vw, 186px\" \/><\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">Por que acontece?<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #000000;\"><span style=\"color: #808080;\">Durante a vida embrion\u00e1ria, o umbigo \u00e9 formado por diversas estruturas como saco vitelino, alant\u00f3ide, \u00e2mnio e vasos umbilicais. Parte do desenvolvimento do intestino, nesse per\u00edodo ocorre fora do corpo do embri\u00e3o, atrav\u00e9s do anel umbilical. O retorno do intestino ao interior do beb\u00ea ocorre at\u00e9 10<sup>a <\/sup>semana de gesta\u00e7\u00e3o, quando ent\u00e3o ocorrer\u00e1 produ\u00e7\u00e3o um tecido conectivo denso que ir\u00e1 ocupar o anel umbilical. Ap\u00f3s o nascimento as estruturas que comp\u00f5em o umbigo perder\u00e3o sua fun\u00e7\u00e3o e com isso acontece uma contra\u00e7\u00e3o do anel umbilical at\u00e9 que se feche totalmente. As crian\u00e7as com h\u00e9rnia umbilical apresentam falha nesse processo de fechamento.<\/span><\/span><\/p>\n<p><span style=\"color: #808080;\"><a style=\"color: #808080;\" href=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-03.png\"><img decoding=\"async\" loading=\"lazy\" class=\"  wp-image-168 alignleft\" src=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-03-300x117.png\" alt=\"H\u00e9rnia umbilical 03\" width=\"426\" height=\"166\" srcset=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-03-300x117.png 300w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-03-600x234.png 600w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-03.png 865w\" sizes=\"(max-width: 426px) 100vw, 426px\" \/><\/a><\/span><\/p>\n<hr \/>\n<p><span style=\"color: #808080;\">Incid\u00eancia<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">A incid\u00eancia geral \u00e9 de 20%, mas alguns fatores de risco fazem essa frequ\u00eancia aumentar. Crian\u00e7as da ra\u00e7a negra t\u00eam 2 vezes mais chance de apresentar o problema. A desnutri\u00e7\u00e3o tamb\u00e9m \u00e9 um fator de risco importante assim como a prematuridade. Beb\u00eas prematuros, entre 1kg e 1,5kg, apresentam uma chance de at\u00e9 80% de possu\u00edrem h\u00e9rnia umbilical.<\/span><\/p>\n<p style=\"text-align: left;\"><span style=\"color: #808080;\"><a style=\"color: #808080;\" href=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/hernia-inguinal-prematuro.jpg\"><img decoding=\"async\" loading=\"lazy\" class=\"  wp-image-195 alignleft\" src=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/hernia-inguinal-prematuro-300x208.jpg\" alt=\"hernia inguinal prematuro\" width=\"339\" height=\"235\" srcset=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/hernia-inguinal-prematuro-300x208.jpg 300w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/hernia-inguinal-prematuro.jpg 393w\" sizes=\"(max-width: 339px) 100vw, 339px\" \/><\/a><\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">\u00c9 perigoso?<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">Raramente na crian\u00e7a ocorre alguma complica\u00e7\u00e3o como encarceramento, estrangulamento ou perfura\u00e7\u00e3o. A dor abdominal \u00e9 uma preocupa\u00e7\u00e3o constante dos pais, entretanto, exceto quando ocorre alguma das complica\u00e7\u00f5es acima, a h\u00e9rnia umbilical n\u00e3o \u00e9 a respons\u00e1vel por essa queixa. Na grande maioria dos casos n\u00e3o h\u00e1 sintomas e \u00e9 bastante comum n\u00e3o ser notada pelos pais at\u00e9 ficarem maiores ou serem percebidas durante consultas por outros motivos.<\/span><\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_170\" aria-labelledby=\"figcaption_attachment_170\" class=\"wp-caption alignleft\" style=\"width: 241px\"><a style=\"color: #808080;\" href=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-05.png\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-170\" src=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-05-242x300.png\" alt=\"H\u00e9rnia umbilical 05\" width=\"241\" height=\"299\" srcset=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-05-242x300.png 242w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-05.png 362w\" sizes=\"(max-width: 241px) 100vw, 241px\" \/><\/a><figcaption id=\"figcaption_attachment_170\" class=\"wp-caption-text\"><span style=\"color: #808080;\">H\u00e9rnia umbilical estrangulada<\/span><\/figcaption><\/figure>\n<p><span style=\"color: #808080;\"><a style=\"color: #808080;\" href=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-04.png\"><img decoding=\"async\" loading=\"lazy\" class=\" wp-image-169 alignleft\" src=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-04-298x300.png\" alt=\"H\u00e9rnia umbilical 04\" width=\"330\" height=\"332\" srcset=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-04-298x300.png 298w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-04-150x150.png 150w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-04.png 449w\" sizes=\"(max-width: 330px) 100vw, 330px\" \/><\/a> <\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">Quando operar?<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">Dos beb\u00eas que apresentam h\u00e9rnia umbilical, cerca de 80% apresentar\u00e3o fechamento espont\u00e2neo at\u00e9 os 3 anos de idade devido ao aumento da musculatura abdominal e quanto menor a h\u00e9rnia, maior essa chance. As menores que 1 cm provavelmente fechar\u00e3o sozinhas, sendo mais dif\u00edcil nas acima de 1,5 cm e improv\u00e1vel nas maiores que 2 cm. Dessa forma a cirurgia est\u00e1 indicada nas crian\u00e7as acima de 3 anos e nas h\u00e9rnia ma<\/span><br \/>\n<span style=\"color: #808080;\">ores que 2 cm ou que apresentem alguma complica\u00e7\u00e3o.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">Como \u00e9 a cirurgia?<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">A crian\u00e7a recebe anestesia geral e o procedimento cir\u00fargico \u00e9 relizado da seguinte forma:<\/span><\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_171\" aria-labelledby=\"figcaption_attachment_171\" class=\"wp-caption aligncenter\" style=\"width: 282px\"><a style=\"color: #808080;\" href=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-06.png\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-171 size-medium\" src=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-06-282x300.png\" alt=\"H\u00e9rnia umbilical 06\" width=\"282\" height=\"300\" srcset=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-06-282x300.png 282w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-06.png 517w\" sizes=\"(max-width: 282px) 100vw, 282px\" \/><\/a><figcaption id=\"figcaption_attachment_171\" class=\"wp-caption-text\"><span style=\"color: #808080;\">Incis\u00e3o semi-circular na margem inferior do umbigo<\/span><\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_172\" aria-labelledby=\"figcaption_attachment_172\" class=\"wp-caption aligncenter\" style=\"width: 300px\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-172 size-medium\" src=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-07-300x279.png\" alt=\"H\u00e9rnia umbilical 07\" width=\"300\" height=\"279\" srcset=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-07-300x279.png 300w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-07.png 560w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"figcaption_attachment_172\" class=\"wp-caption-text\"><span style=\"color: #808080;\">Isolamento do saco herni\u00e1rio<\/span><\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_173\" aria-labelledby=\"figcaption_attachment_173\" class=\"wp-caption aligncenter\" style=\"width: 300px\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-173 size-medium\" src=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-08-300x288.png\" alt=\"H\u00e9rnia umbilical 08\" width=\"300\" height=\"288\" srcset=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-08-300x288.png 300w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-08.png 520w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"figcaption_attachment_173\" class=\"wp-caption-text\"><span style=\"color: #808080;\">Separa\u00e7\u00e3o do saco herni\u00e1rio da cicatriz umbilical<\/span><\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_174\" aria-labelledby=\"figcaption_attachment_174\" class=\"wp-caption aligncenter\" style=\"width: 300px\"><a style=\"color: #808080;\" href=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-09.png\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-174 size-medium\" src=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-09-300x292.png\" alt=\"H\u00e9rnia umbilical 09\" width=\"300\" height=\"292\" srcset=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-09-300x292.png 300w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-09.png 520w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"figcaption_attachment_174\" class=\"wp-caption-text\"><span style=\"color: #808080;\">Fechamento do orif\u00edcio herni\u00e1rio e fixa\u00e7\u00e3o da cicatriz umbilical<\/span><\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_175\" aria-labelledby=\"figcaption_attachment_175\" class=\"wp-caption aligncenter\" style=\"width: 270px\"><a style=\"color: #808080;\" href=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-10.png\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-175 size-medium\" src=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-10-270x300.png\" alt=\"H\u00e9rnia umbilical 10\" width=\"270\" height=\"300\" srcset=\"http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-10-270x300.png 270w, http:\/\/drdouglascaetano.med.br\/web\/wp-content\/uploads\/2015\/08\/H\u00e9rnia-umbilical-10.png 580w\" sizes=\"(max-width: 270px) 100vw, 270px\" \/><\/a><figcaption id=\"figcaption_attachment_175\" class=\"wp-caption-text\"><span style=\"color: #808080;\">Fechamento da pele com pontos intrad\u00e9rmicos<\/span><\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">Recupera\u00e7\u00e3o<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #808080;\">Geralmente a crian\u00e7a sente pouca dor no p\u00f3s-operat\u00f3rio e se recupera rapidamente. O resultado est\u00e9tico final ocorre ap\u00f3s 3 a 6 meses. H\u00e9rnias maiores podem demorar um pouco mais para a acomoda\u00e7\u00e3o da pele em excesso. O retorno \u00e0s aulas se d\u00e1 em 5 a 7 dias, devendo a crian\u00e7a se manter afastada da educa\u00e7\u00e3o f\u00edsica por pelo menos 30 dias.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>H\u00e9rnia Umbilical &nbsp; O que \u00e9? &nbsp; \u00c9 o defeito do fechamento da estrutura fibromuscular do anel umbilical, permitindo a protrus\u00e3o de \u00f3rg\u00e3os intra-abdominal atrav\u00e9s da falha, que pode ser notada como abaulamento da \u00a0 cicatriz umbilical. Geralmente al\u00e7as intestinais. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Por que acontece? &nbsp; Durante [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":18,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"http:\/\/drdouglascaetano.med.br\/web\/index.php?rest_route=\/wp\/v2\/pages\/165"}],"collection":[{"href":"http:\/\/drdouglascaetano.med.br\/web\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/drdouglascaetano.med.br\/web\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/drdouglascaetano.med.br\/web\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/drdouglascaetano.med.br\/web\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=165"}],"version-history":[{"count":11,"href":"http:\/\/drdouglascaetano.med.br\/web\/index.php?rest_route=\/wp\/v2\/pages\/165\/revisions"}],"predecessor-version":[{"id":222,"href":"http:\/\/drdouglascaetano.med.br\/web\/index.php?rest_route=\/wp\/v2\/pages\/165\/revisions\/222"}],"up":[{"embeddable":true,"href":"http:\/\/drdouglascaetano.med.br\/web\/index.php?rest_route=\/wp\/v2\/pages\/18"}],"wp:attachment":[{"href":"http:\/\/drdouglascaetano.med.br\/web\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=165"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}