Epigastric hernia : A guide to Hernias

An epigastric hernia is similar to an umbilical hernia in that it mainly affects babies and young children rather than adults. It develops in almost a similar way to an umbilical hernia - except that it occurs in the area between the chest and belly button – known as the ‘epigastrium’.

It very often fixes itself without any need for treatment. As the baby grows, its abdominal muscles develop and strengthen which result in the hernia retracting (going back) into place.

An epigastric hernia is a small type of hernia and as a result of this, only the abdominal wall lining – known as the ‘peritoneum’, protrudes through this wall. But in some cases, it can be large enough to the extent that a part of an internal organ, e.g. the intestine, will push through the abdominal wall.

What is the epigastrium?

The epigastrium is the central, upper part of the abdomen which contains the following internal organs:

• Pancreas
• Liver
• Part of the stomach
• The duodenum (part of the lower intestine)

The difference between this and the umbilical hernia is that the umbilical version occurs around the navel (belly button) whereas the epigastric hernia occurs a little higher up in the abdomen.

The causes of an epigastric hernia

This type of hernia often occurs at birth although it can develop in adults as well. With adults, it can be caused by an underlying weakness in the abdominal wall, lifting heavy objects, coughing, straining on the toilet, being overweight or a build up of fluid within the abdomen.

Symptoms of an epigastric hernia

There will be a noticeable lump in babies and very young children which is apparent when the child cries; has a bowel movement or moves in a certain way which puts pressure on the abdomen.

The hernia will appear and disappear at intervals –known as a ‘reducible’hernia but will not fix itself. Treatment in the form of surgery is required to do this and prevent the risk of a strangulated hernia.

If the hernia becomes tender to the touch, deep red in colour and is accompanied by nausea, vomiting and severe pain then emergency surgery is required.

If you have a child with a hernia then seek urgent medical attention if this develops into a strangulated hernia. This is a potentially dangerous condition and must be seen to as soon as possible.

Diagnosing an epigastric hernia

This is easy to do as your GP will notice this small lump when he/she carries out a physical examination.

Treatment for an epigastric hernia

Surgery is the recommended option although this may be postponed in the case of a very young child. If there is no risk of the hernia becoming strangulated then your GP may advise waiting until your child is older.

Find out more in our hernias and children section.

There are two types of procedure for hernia repair:

• Keyhole surgery
• Open surgery

Keyhole surgery works well with small hernias but larger ones are often better suited to open surgery.

Both of these procedures are discussed further in our treatment for hernias section.

Other types of hernia include:

• Hiatus hernia
• Inguinal hernia
• Femoral hernia
• Umbilical hernia
• Incisional hernia
• Spigelian hernia
• Sports hernia