An epigastric hernia is also called abdominal wall rupture. It describes a bulge of the abdominal wall between navel and sternum. The contents of the abdominal cavity pass through a weak point of the abdominal wall to the outside. At the beginning, this can only be felt with tummy tautness, later also entrails can get into the bag and pinch it there. This represents a life-threatening emergency that needs to be operated as soon as possible. Read more about the symptoms, diagnosis and treatment of epigastric hernia here.
Epigastric hernia: description
Doctors refer to a hernia or abdominal wall fracture when the abdominal wall bulges outward at a weak point of the abdominal wall and forms a so-called fractured sac. Almost one percent of all Germans suffer a hernia every year – 200,000 of them need surgery to prevent complications. Epigastric hernias are rare compared to other hernias, accounting for five percent. Men are three times more likely to be affected than women.
A hernia can either be innate or occur during the course of life. In children, these hernias are often associated with embryonic development. If the testicle in the infant has not yet fully slipped into the testicles, this usually still happens in the first year of life. There remains an opening between the testicles and abdominal cavity, through which the testicles can migrate. Organs can also slip into this connection and this is called a hernia.
The epigastric hernia occurs in children and adults, typically between the sternum and belly button – sometimes in several places at the same time. Important is the difference to the rectus diastase: Here it comes by a divergence of the straight abdominal muscles (six-pack) to a uniform increase in the midline (linea alba) between the navel and sternum. By definition, rectal diastasis is not referred to as hernia, as there is no hernial sac in which bowels can become entangled. There is no danger here, and surgery has the primary goal of achieving a more aesthetic result.
Epigastric hernia: symptoms
The epigastric hernia does not have to cause any discomfort or pain. Nevertheless, you should consult a doctor for further clarification. Most chronic pressure complaints on the upper abdomen, which can increase when straightening, sneezing or defecating are typical complaints when abdominal wall fracture. Symptoms such as sudden pain in the hernia region indicate an obstruction of abdominal organs in the hernia sac – the blood supply to the organ can be interrupted. In that case you should urgently go to the doctor. Nausea and vomiting are other typical complaints.
Epigastric hernia: causes and risk factors
Although some children are already born with the diagnosis epigastric hernia, it tends to occur in the elderly. Because the increasing weakness of connective tissue in old age favors hernia. Even in overweight people, the connective tissue is often weakened, so it comes increasingly to tears and hernias. High pressure inside the abdominal cavity due to chronic constipation, or heavy lifting also promotes the development of hernias. An important risk factor is the family history. If a hernia disorder is known in one’s own family, in parents, siblings or grandparents, there is an increased risk of suffering an abdominal wall tear in the course of his life.
Epigastric hernia: examinations and diagnosis
If you suspect you have an epigastric hernia, it is best to consult your family doctor or a gastroenterologist. This will first look for the conversation with you (anamnesis). This is followed by a physical examination. The doctor asks the patient to cough or tense the abdomen in order to feel changes. Because the abdominal pressure is increased, can usually palpate a bulge. This fractured under pressure hernia bag confirms the diagnosis of the abdominal wall.
Epigastric hernia: treatment
The epigastric hernia has a low risk of entrapment of abdominal organs, so that therapy is usually recommended only in case of discomfort. In this case, the surgeon removes the hernia bag surgically and relocates the hernia bag contents back into the abdomen. By means of the storage of plastic nets, the doctor can strengthen the abdominal wall to prevent the re-emergence of a fractured bag.
Epigastric hernia: disease course and prognosis
The epigastric hernia is a harmless disease. As a rule, patients have no complaints for many years. If complications occur, surgery is necessary. Basically, it makes sense to prevent risk factors such as excessive obesity or heavy lifting.