Hernias
Epigastric hernia
A small midline defect between the sternum and the umbilicus. It can be isolated or coexist with umbilical hernia or rectus diastasis.
Symptoms
- Small bulge above the belly button on the midline
- Central upper abdominal pain
- Burning, tension or discomfort
- Symptoms that worsen with coughing, sport or weight lifting
Diagnosis and treatment
The diagnosis is clinical and confirmed with ultrasound. Because epigastric hernias often coexist with other midline defects, the whole linea alba is assessed.
Treatment can be open, laparoscopic or robotic, depending on the size and association with diastasis or umbilical hernia. Mesh is used when it is needed to reinforce the wall.
As with any hernia, urgent assessment is needed if the bulge becomes hard, painful, non-reducible or associated with nausea or vomiting.
Surgical options
- Open sutured or mesh repair for small isolated defects
- Laparoscopic or robotic repair for larger or recurrent defects
- Combined repair of the whole linea alba when multiple midline defects coexist
