What is an Epigastric hernia?

Epigastric hernias are lumps or bulges that occur in the upper part of the patient’s abdominal wall, in the site known as the epigastrium, which is just below the breastbone and above the navel. Epigastric hernias can be present since birth. They may differ in size, and it is possible to have more than one epigastric hernia at the same time. Generally, an epigastric hernia is small, with only the lining of the abdomen breaking through the surrounding tissue. Larger hernias may result in a part of the stomach or fatty tissue to push through. For many people, small hernias do not result in some problems, may only be visible at certain times, and may even remain unnoticeable when lying down. Many of the people are even unaware that they have an epigastric hernia.

Symptoms of Epigastric Hernia are:

The individual with epigastric hernias usually does not experience any symptoms. Some people go through childhood and adolescence unknowingly they have an epigastric hernia. However, many children feel the symptoms at a young age.

Symptoms in both adults and children include the following:

• Pain
• Tenderness
• An abdominal bump that can be felt and seen

Certain actions such as crying, straining, or having a bowel movement, may cause or worsen these symptoms. The symptoms of some epigastric hernias just come and go, which is called a reducible hernia.

Treatment in Children

An epigastric hernia will not heal by itself and does need surgery to get repaired. However, unless the hernia threatens to become an emergency, surgery can be postponed until the child has become older. Toddlers are better at tolerating the surgery better than the newborns, so it may be beneficial to wait before the operation is being performed.

Treatment in Adults

It is not uncommon for an adult to be diagnosed with an epigastric hernia that they were unaware of earlier in life. There is also a possibility that the hernia that was known to be present for many years to become a major issue later as the individual ages. For many of the people, a hernia does not result in symptoms until later in their life due to muscle weakness, strain, or obesity on the muscular wall of the abdomen. In these cases, surgical repair may be required if the hernia results in pain or threatens to become strangulated.

Causes and risk factors

An epigastric hernia is generally present since birth. An Epigastric hernia is formed as the result of a weakness in the patient’s abdominal wall muscles or incomplete closure of abdominal tissue during the development.

Some factors that may cause or worsen epigastric hernias include:

• Obesity
• Pregnancy
• Coughing fits
• Heavy Lifting
• Physical Labor
• Intensive sports or training

Procedure for the surgery of the Epigastric Hernia Repair

Surgical repair can be performed either under the general anesthetic or under the local anesthetic, generally depends on the preference of the patients and the advice given by the surgeon. Once the anesthetic is being given to the patients and has taken its course, the surgeon will make a cut in the hernia and then a laparoscope, which is a thin tube with a light that allows the surgeon to view the patient’s abdominal organs and hernia, is being inserted in to the body through that cut. The surgeon will then make another cut for other surgical instruments. The surgeon will place the hernia sac to its correct position. The surgeons will also strengthen the muscle of the patient’s abdominal wall. If the site resulting in the muscular weakness is small, the surgeon may stitch it up. These permanent stitches are called sutures, and these stitches will restrict the hernia from pushing through again. Large areas of muscular weakness may need a patch of nylon mesh, which is stitched in place to cover up the hole. But, this may not be suitable for those people who have previously rejected other surgical implants. Once the hernia sac is in the correct place and the suture or mesh is in the position, the surgeon will then remove the laparoscope and close the surgical cut. Dissolvable stitches are generally used to close the surgical wound. The surgeon will then cover the wound with the help of a waterproof dressing.

How soon will The Patients recover?

The patients should be able to go home the same day as the surgery is being performed. The patients must gradually increase how much they can walk around over the first few days. The patients should be able to return to their work after 1 to 2 weeks, depending on how much surgery they require and also on their type of work. Regular exercise should help the patients to return to their day to day activities as soon as possible. Before the patients start exercising, they must ask the healthcare team or their GP for the advice. The patients must keep in mind that the hernia can return back.

Benefits of Epigastric Hernia Repair Surgery are:

The patients will no longer have the hernia. Surgery can help in relieving pain that is being caused due to the hernia. The patients may still experience pain if it is caused by any other problem.

Alternatives to Epigastric Hernia Repair Surgery are:

The hernia can be left alone but the pain caused by the hernia will generally continue and the complications can occur. The hernia will not get better without surgery is being performed.

Complications that can be resulted due to Epigastric Hernia Repair:

General complications due to Epigastric Hernia Repair are:

• Pain
• Bleeding
• Infection of the surgical wound
• Unsightly scarring
• Blood clotting

Specific complications due to Epigastric Hernia Repair are:

• Developing a collection of fluid or blood
• Injuries to the structures within the patient’s abdomen

Outlook

An epigastric hernia is a common condition caused by a weakness in an individual’s abdominal wall between the umbilicus and the sternum. If an epigastric hernia is left untreated, this can result in some serious complications.