Overview

A hernia is a generic term for a hole caused by a weak spot in your abdominal wall. An epigastric hernia is a type of hernia in the epigastric region of the abdominal wall. It’s above the belly button and just below the sternum of your rib cage.

This type of hernia is a somewhat common condition in both adults and children. About 2 to 3 percent of all abdominal hernias are epigastric hernias. It’s also seen in infants.

Most of the time, you’ll have no symptoms or only minor symptoms with an epigastric hernia. A lack of symptoms means that this condition tends to go unreported.

Symptoms of an epigastric hernia

An epigastric hernia usually causes a bump to occur in the area below your sternum, or breastbone, and above your belly button. This bump is caused by a mass of fat that has pushed through the hernia.

The raised area may be visible all the time or only when you cough, sneeze, or laugh. This bump, or mass, can grow and become larger in some cases. You can have more than one epigastric hernia at a time.

An epigastric hernia can also cause tenderness and pain in the epigastric region. However, it’s common for an epigastric hernia not to show any symptoms.

Causes of an epigastric hernia

An epigastric hernia can occur when the tissues in the abdominal wall don’t close completely during development. Research continues to look for the specific causes of this type of hernia. Not as much is known about epigastric hernias possibly because they aren’t reported many times due to a lack of symptoms.

However, one theory has gained some credibility. It’s believed that the epigastric hernia may be caused when there is tension in the area where the abdominal wall in the epigastric region attaches to the diaphragm.

Treatment options for this condition

This type of hernia won’t go away on its own, and complications will eventually lead you to surgery. Surgery is the only way to repair an epigastric hernia. It’s the recommended treatment, even for infants, due to the risk of the hernia enlarging and causing additional complications and pain.

To complete the repair, you might only need sutures, or you may require an implanted mesh. The use of mesh or sutures is determined by the size of the hernia and other factors.

Emergency symptoms of an epigastric hernia

If your epigastric hernia hasn’t been treated, you should get medical treatment immediately if you have vomiting or fevers and an increase in abdominal pain. These may indicate a bowel blockage.

Surgery to repair an epigastric hernia can lead to certain serious complications. If you have any of the following symptoms after surgery, you should seek medical attention:

  • high fever
  • difficulty urinating
  • discharge from the surgical site
  • an increase in pain or swelling at the surgical site
  • bleeding that won’t stop
  • nausea
  • vomiting

Complications and risks of an untreated epigastric hernia

The complications for an untreated epigastric hernia include the following:

  • enlarged hernia, which eventual allows parts of the bowel to push through
  • increase or onset of pain and tenderness
  • bowel blockage
  • loss of domain, in which the hernia becomes so large that’s nearly impossible to repair even with a mesh

The complications for the surgical repair of epigastric hernia includes any basic complications surrounding surgery and general anesthesia as well as those related to this specific surgical procedure. These complications may include:

  • bleeding
  • pain
  • wound infection at the surgical site
  • scarring left after healing
  • blood clots
  • development of a lump that isn’t a hernia
  • a low chance of the hernia recurring
  • mesh infection (in the event an artificial mesh is used to repair the hernia)

Outlook

Surgical repair of an epigastric hernia is a common procedure and has a very positive outlook. Most people are able to go home the same day as the surgery.

You might even be able to return to work or school within a day or two with some minor restrictions. Specifically, most surgeons don’t want you lifting any weight heavier than a gallon of milk for six to eight weeks.

Your doctor will tell you how quickly you should return to your normal activities. Usually, your restrictions will include no heavy lifting and no strenuous activities or sports for a brief period of time.