Epigastric Hernias

What Is an Epigastric Hernia?

An epigastric (eh-pih-GAS-trik) hernia is when part of the intestines pushes through the abdominal muscles between the belly button and the chest.

Many are small, cause no symptoms, and don't need treatment. Larger ones that do cause symptoms won't heal on their own, but surgery can fix the problem.

What Causes Epigastric Hernias?

A hernia is when part of the intestine bulges through the muscle wall that's supposed to hold it in place. With an epigastric hernia, the opening is near the center of the abdomen (belly), between the bottom of the breastbone (sternum) and the belly button. This area is called the epigastrium.

Epigastric hernias happen because of problems where the abdominal muscles on both sides come together. This lets fatty tissue push through the muscles, causing pain and a small lump.

Babies can be born with this problem, or it can happen later because of weakness in the surrounding muscles or strain on the abdominal wall.

Who Gets Epigastric Hernias?

About 75% of epigastric hernias happen in males.

What Are the Signs & Symptoms of Epigastric Hernias?

Most epigastric hernias don't cause symptoms. When they do, a child might have:

• a small bump or swelling above the belly button
• discomfort or pain

The pain may get worse when the child stands, sneezes, coughs, or strains to go to the bathroom.

How Are Epigastric Hernias Diagnosed?

Doctors can diagnose an epigastric hernia by doing an exam to look for a bump and asking about a child's symptoms, such as pain.

How Are Epigastric Hernias Treated?

Epigastric hernias don't go away without treatment. So doctors may repair them with surgery if a hernia causes symptoms.

To operate, doctors will:

• Give anesthesia so the child sleeps through the procedure and won't feel any pain.
• Make a small incision (cut) in the skin.
• Remove the fat poking through the hernia defect or push it back into the abdomen.
• Close the hole or weak spot in the muscle with stitches.
• Close the incision with absorbable sutures under the skin and tape strips. The strips will fall off on their own in 1–2 weeks.

What Happens After the Surgery?

Most children can go home a few hours after the surgery. Things to know:

• Your child should have a sponge bath for the next week rather than a tub bath or shower.
• Your child may have some swelling and bruising near the surgery area. Apply cool compresses (a cloth dipped in cold water, a freezer pack, or a bag of ice) to the area to reduce swelling. Wrap it in a towel to protect the skin.
• Kids can eat normally and go back to their usual activities as soon as they feel up to it, usually in a few days. They should avoid sports and gym for a few weeks.
• Some kids get constipated (have trouble pooping) after surgery. Offer plenty of liquids, such as water and prune, pear, and apple juice. Serve high-fiber fruits and vegetables, such as pears, strawberries, and sweet potatoes. Avoid cheese, bananas, and white rice.
• Your child should not climb, play sports, or lift objects heavier than 10 pounds (about the weight of a gallon of milk) until the surgeon says it's OK.
• Give any prescribed medicine or over-the-counter pain medicine exactly as directed.

When Should I Call the Doctor?

Call the surgeon if your child had surgery and:

• has a fever of 101.5°F or higher for more than 24 hours
• has redness that spreads around the surgery area
• has bleeding, swelling, or drainage from the surgery area
• has severe, lasting pain at the surgery area
• can't pee within 8–12 hours after surgery
• is vomiting
• you have any other concerns