What is Epigastric Hernia: Types, Causes, Symptoms, Complications, Diagnosis

What is Epigastric Hernia?

Epigastric hernia is small in size and one can have them more than one at a time. It is a complication that happens to be in the middle of the stomach that is between the breastbone and the navel /belly button. It occurs when fat impulses past the weakest portion of belly wall. There are no prior symptoms for epigastric hernia but if you have one it might give you severe pain in the upper abdomen. To get rid of epigastric hernia one must talk to her/his doctor and know about the choices of treatments or you can also go for the surgery option for epigastric hernia.

When the tissues in the stomach bulge through the muscle due to feebleness in the abdominal muscle an epigastric hernia occurs. Infants may have epigastric hernia in their stomach when they are born. It can be healed automatically as the baby grows and his/her stomach muscle strengthens. This type is similar to the umbilical hernia, except the fact that an epigastric hernia is between the breastbone and the navel but umbilical hernia forms around the navel itself. An epigastric hernia is small which makes the empty space in the abdomen push through the muscle wall sometimes due to which the portions of the organs move past the hole in the muscle.

What is Epigastric Hernia?

Epigastric Hernia in Children and Infants

Epigastric hernia can occur in children and infants. An epigastric hernia is a condition in which the weakness in the tissues of the stomach makes a bulge through the muscle between the navel and the breastbone. Epigastric hernias are sometimes there in the infants when they are born. This can be caused because the fibrous tissue of the stomach did not get a complete conclusion during development. Sometimes they are noticed because of the clot of fat in the abdomen is stuck in the epigastric hernia. When the bump will push out from the center of the stomach, it will get in notice with the child crying or passing stool or bending down. The bump gets back to the abdomen as the child is in normal positions. This bump is usually full of fluids or fats. Pain can be the only symptom to know that the child is suffering from epigastric hernia.

These can be treated automatically as the child grows. Umbilical hernias generally get treated without any surgery but epigastric hernias do not resolve on their own. The treatment totally depends on the age of the child and also the size of the epigastric hernia. With only a petty issue the doctors tend to wait and watch the approach of the child and the epigastric hernia. Sometimes, the epigastric hernia gets resolved when the muscles get strengthened and the wall in the abdomen matures. There are fewer chances of these to become serious problems. Smaller clots turn red and painful as it entraps the fluids or fats whereas larger ones trap intestines in the lump which can lead to blockage or damage of the intestine. It can also lead to blood flow to the intestines which can be a serious complication. Surgery is the only solution to such complications of epigastric hernia.

The surgery does not lead to severe pain among children. But as a precaution children who have undergone the epigastric hernia repair are prescribed with pain relief medicines such as tylenol or advil for children. Surgery strips are supposed to be there for a minimum of 10 days to prevent from infections after epigastric hernia repair. Swimming and tub bathe is not suggested while the child is allowed to take a shower. After 2 weeks of operation the child is asked to visit the pediatric surgery clinic to get a check-up done for epigastric hernia.

Types of Epigastric Hernia

There are two different types of epigastric hernia. Reducible epigastric hernia and Incarcerated epigastric hernia are two types of epigastric hernia. The Reducible epigastric hernia type is when the tissue keeps pushing out of the hole and then getting back in there whereas the incarcerated epigastric hernia is when the tissue becomes a lump. This is the type which is the most serious but is not considered as an emergency.

Causes of Epigastric Hernia

There can be several causes which can get you epigastric hernia. The main reason for epigastric hernia in the belly is the lesser strength or an inborn defect in the walls of your stomach or the connective tissue. These can make the walls in your stomach feeble. It can be caused also in any of your abdominal organs like liver or stomach. Also a small portion of your intestines can be caught up in your weak abdominal wall. There are also other causes which can form a lump between your chest and belly button. Causes of epigastric hernia may include:

  • Obesity can cause epigastric hernia.
  • Pregnancy might cause epigastric hernia.
  • Having an accumulation of fluid in your stomach cavity might lead to epigastric hernia.
  • Lifting objects that are too heavy for you constantly can cause epigastric hernia.
  • Straining when you are having a bowel movement
  • Sometimes persistent coughing may cause epigastric hernia.

Signs and Symptoms of Epigastric Hernia

There might be multiple signs and symptoms for epigastric hernia. A swelling will be noticeable when there will be pressure on the abdomen by moving or doing any activity. The symptoms of epigastric hernia are minor in the beginning but that also can be a serious complication. In some cases even death can occur as the other organs in the stomach get infected and it can also get through the peritoneum, which is a membrane between the organs and the abdominal cavity. There are other symptoms of having an epigastric hernia which are as follows:

  • Firstly for epigastric hernia patients, there will be a noticeable bump in their stomach which will be felt when the person is either bending to get or do something or when he has a bowel movement. The application can also result from coughing, crying and laughing. These can cause a pressure on your belly giving them a pudginess feeling.
  • Second sign of epigastric hernia, there will be a slight change in the color of your skin. The area effected with epigastric hernia will be blackish-blue in color. This can be an indication for you to visit the doctor immediately as this symptom is serious as the skin color changes only when epigastric hernia becomes strangled. This happens when the blood flow does not even touch the epigastric hernia. Sometimes you experience diarrhea, abdominal swelling, vomiting and pain with the strangulated hernia.
  • Third symptom of epigastric hernia, your upper belly experiences unbearable or severe pain. When the epigastric hernia gets larger and gets trapped in the stomach’s muscular wall you may get encountered with such pain. Sometimes there is a rough patch around the area affected.
  • A fever running ranging from low to high can be a complicated epigastric hernia because a person with simple epigastric hernia does not go through fever. Also if the fever is accompanied with nausea or vomiting immediate medical attention is suggested.
  • There is also a probability that your epigastric hernia is not at all visible. And you might get to know about it very late. Whereas sometimes it is immediately noticeable.

Complications in Epigastric Hernia

A lot of complications may pop up if the epigastric hernia is not treated properly or on time. There may be loops of bowel when the weakness in the muscle wall enlarges. Due to this if a person is not able to push the epigastric hernia back; a blockage may cause which will result in vomiting and stomachache. This complication should be immediately taken to the doctor the patient may need an emergency operation.

Tests to Diagnose Epigastric Hernia

There are few tests to diagnose epigastric hernia. Few of the tests are simple whereas few are complicated. To diagnose an epigastric hernia the doctor will ask you to move so that he can easily see the appearance of the epigastric hernia. Firstly, he will take a physical examination by making you cough so that he can see the bulge on your stomach. Secondly, he may ask you to lie down with your legs bent to feel the bulge accurately. Thirdly, your healthcare provider may take an ultrasound or CT scan to clearly take an internal look at the clot. You may need any of the following:

  • Abdominal ultrasound for diagnosing epigastric hernia is done so that the doctors can see the internal organs and tissues of your stomach and study it carefully. A type of gel will be put on your belly and a sensor will be moved across it. This will get all the pictures of your stomach internally and show it in a small screen.
  • CT scan for diagnosing epigastric hernia is a kind of an x-ray machine that uses a computer to take all the internal pictures of your stomach. This scan may reveal a lot about the epigastric hernia. You may know about the size of it and also the reason of its occurrence. One may get a dye before the pictures are taken. Some people who are allergic to shell fish may also be allergic to some dyes. Let your health care provider know about your allergies before starting with the scan.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 16, 2022

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