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Some time ago I read a paper entitled "Urgent Conditions in Abdominal Surgery," in which I strongly advised closure of all umbilical hernias before any strangulation takes place. For the past six months I have been asked so often to operate for strangulated umbilical hernia that I again call attention to this urgent condition.
Umbilical hernia is a common condition. In many particulars this hernia is unfavorable for a prolonged operation, and therefore I make a plea for more prophylactic surgery. The patient is as a rule aged between 45 and 60 years, and is a fleshy person with poor resisting powers. The pathology of the umbilical hernia much complicates the condition. That typically honeycombed dissection of the viscera between the fascia and the skin, which is so characteristic of umbilical hernia, makes the operation long and tedious. In this class of cases the strangulation is often incipient in onset;
KENNEDY JW. PLEA FOR EARLY SURGICAL INTERVENTION IN ALL UMBILICAL HERNIAS. JAMA. 1912;LIX(25):2251-2252. doi:10.1001/jama.1912.04270140055020