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Epigastric Hernia

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A hernia is caused by a weakness in muscle wall tissue, usually in the abdominal area.

The main difference in the various types of hernias is where these weak spots develop. What’s termed an epigastric hernia affects the area around the sternum and belly button near the ribcage known as the epigastric region.

People of all ages, from infants to adults, may develop a visible bump from this type of hernia that’s caused by the protrusion of a mass of fat through the weakened spot.

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What Causes an Epigastric Hernia?

An epigastric hernia isn’t entirely preventable since it’s caused by a failure of the abdominal wall to fully close during development. While it’s not fully understood why this happen, one suggestion is that tension in the part of the diaphragm that’s attached to the abdominal wall in the epigastric region may be a contributing factor.

How Can You Tell If You Have One?

Epigastric hernias often go untreated and under-reported because symptoms can be either non-existent or minor. The most obvious sign of this type of hernia is a noticeable bulge in the area above the belly button. Depending on the extent of the protrusion through the weak spot, the bulge may be constantly visible or only noticeable when forceful actions (e.g., coughing, hearty laughing, sneezing) take place. Tenderness and pain in the affected area is the most common symptom associated with an epigastric hernia.

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How Is an Epigastric Hernia Diagnosed and Treated?

Diagnosis is usually made when a bulge in the epigastric region becomes noticeable. During a physical examination, a doctor may gently press the affected area while the patient is in various seated, lying down, and standing positions. To get an idea of the extent of the protrusion through the weak spot in the abdominal wall, an ultrasound may be done. In some cases, other image tests are performed.

An epigastric hernia is a type of hernia that will not go away on its own. The only viable treatment is surgery. While some people with hernias in the epigastric region prefer not to seek treatment, complications often develop over time to the extent that surgery is eventually necessary. The specific approach to surgery will depend on the size of the hernia.

Some patients benefit from minimally invasive, outpatient laparoscopic hernia repair. It’s an approach to surgery that involves the use of special instruments to insert sutures to close the opening in the abdominal lining. The procedure can be performed with incisions made on either side of the hernia. If the opening is fairly large, surgical mesh may be placed over it.

An epigastric hernia that’s not treated may require emergency treatment if abdominal pain suddenly worsens or if vomiting, a high fever, and similar serious symptoms develop. Untreated epigastric hernias may also allow other parts of the bowel to make it through the weak spot to the point where a bowel blockage occurs. There’s also the possibility of the hernia becoming so large that repair with mesh will be either impossible or very difficult. However, most patients respond well to surgery for hernias like this when treatment is sought before serious symptoms develop.

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