What is an Epigastric Hernia?
An epigastric hernia is formed in between the sternum of the rib cage and the navel region (bellybutton) of the abdomen. It accounts for 2-3 percent of hernias formed.
It is seen in infants, children, and adults and it is fairly common. This condition often tends to go unreported, as it is asymptomatic or demonstrates only minor symptoms.
Causes of Epigastric Hernia
The exact cause of epigastric hernia has not been identified. They are formed when developmentally the muscles of the abdominal walls do not close completely.
Although, one theory that seems to be gaining ground is that the epigastric region where the abdominal wall attaches to the diaphragm when under stress can lead to the formation of an epigastric hernia.
The lack of information on the cause of these hernias maybe because they don't get diagnosed.
The formation of a bump or lump in the area below the sternum or just above the navel indicates an epigastric hernia. It is caused by a mass of fat that has pushed through a weakened muscle wall of the abdominal lining.
It becomes more visible while laughing, coughing, or sneezing. At a given time, there could be one or more epigastric hernias formed. In some cases, this lump may grow larger.
Symptoms of Epigastric Hernia
Epigastric hernias generally do not show any symptoms. However, few may develop tenderness and pain around the hernia formed.
Some symptoms of which cannot be neglected and need medical attention are listed as below:
- Fever
- Vomiting
- Abdominal pain which does not relieve
- All of the above are indicative of obstruction of the bowel
Diagnosis for Epigastric Hernia
The doctor performs a physical examination of the lump while the patient is standing.
The patient may be asked to cough to evaluate the lump when strained and whether it causes any pain. If there are no symptoms, the doctor may suggest observing it over a period of time.
Treatment options for Epigastric Hernia
The epigastric hernia has two main treatment options - Open surgery and Laparoscopic surgery
Open Surgery
Treatment for epigastric hernias is generally an open traditional surgery, as the hernia does not go away by itself. This course of treatment is true even for infants.
Surgery in the early stages is generally suggested, to avoid complications later due to the enlargement of the hernia and its consequences (like blockage). The open traditional surgery involves, implanting a mesh and suturing.
The dimension of the hernia determines the size of the mesh.
Laparoscopic Surgery
Epigastric Hernia can also be treated through a single incision laparoscopic surgery. Laparoscopic Epigastric Hernia surgery is usually performed under general anesthesia.
Post-procedure the patient can be discharged the same day or kept under observation overnight depending on the individual case. If the patient is a child, special care should be taken to adequately prepare children for the surgery.
