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I am basing my input on what I know about an umbilical hernia in humans. :D So, it can be fine for years, but sometimes a little more pops out and then the trouble starts. The question is did enough squish through the hole so that the intestines are now pinched and causing pain or worse case...

That looks a great deal like an umbilical hernia. Interesting. I guess it has never been bad enough to pinch her intestine so that she died..... I had something like that once..... You might be able, after a warm relaxing bath, manage to gently squeeze some of it back inside her. :fl