Dear Simone, there is one rule for doctors here in Croatia: when you think too much,stop, and think again, but this time think for the simpliest diagnose. If you have pain in abdomen and an umbilical hernia seen on US then the first thing to think about is abdominal pain caused by hernia :) . There are many conditions in medicine where pain doesnt need to bo localized near the patology . Sometimes pain can be felt on the opossite side of the affected organ. It is known that one of common symptom of myocardial infarction is pain in the left shoulder. Also, infection of the abdominal organs can give many types and localizations of pain. The reason for it is simple: when i see pain, i see nerves, not organs (this is my own phrase:)) . Nerves conduct pain, and nerves are all around, going from perifery to the brain so pain can be localized on its pathway, So just lets go back to your problem. Doctor should tell you the size of hernia and its content which can be only preperitoneal tissue, omentum or even intestines. This dark triangle...hmmm..it can be nothing and everything. I usually dont trust our ultrasonographer because they are strange people... Sometimes they dont see what they need to see or they see what they dont need to see. All i see is that US is operator-dependent diagnostic test... But we shouldnt underestimate this finding. It can be uterine mioma, endometriosis, cyst or tumor. And yes, it can cause pain u re decribing. So what you need to do: 1. CT scan of pelvic and abdominal region. why? as i said, these US findings are always doubtful, CT is a high sensitive test which will find the exact problem for sure. It will tell you the size and severity of hernia and the morfology of this uterine lesion. It can also find some other problems in its early phase.