epigastric hernia

Epigastric hernia, hernia located in the lower chest

Hernia epigastric hernia is located in the lower chest, above the navel, along the midline of the abdomen. A hernia is an abnormal prominence of a structure or tissue, usually in the abdominal wall. If an epigastric hernia, fatty tissue and rarely, intestines, linea alba exceed located below the rib cage. Linea alba or white line is the portion visible connective tissue that stretches from the middle of the abdomen, between the abdominal muscles.
An epigastric hernia appears as a bulge of small lies between ribs and navel. It does not become larger than the size of a golf ball. Epigastric hernia is rarely located in other regions than the linea alba and is usually the result of a congenital defect or weakness in connective tissue or abdominal muscles. Fatty tissue, intestines or other structures may swell and passes through the abdominal wall weakened, but in general, epigastric hernia is too small and is characterized only by the protrusion of the peritoneum or abdominal lining. This type of hernia occurs most frequently at birth.

People at high risk of epigastric hernia

Epigastric hernias are usually present in newborns and can appear and disappear. Therefore epigastric hernia is considered a type of hernia reducible. It is possible that the hernia is not visible unless the patient (usually young children) complain when is making a chair or other activity that creates abdominal pressure. Hernia visibility makes it easy to diagnose without the need of any special test. A physical examination is sufficient.

Symptoms
In most cases, this type of hernia is painless, with few symptoms. Some events include a slight bulge under the skin, which tends to be higher when the abdominal muscles are tense.
On the other hand, when complications occur, the patient may feel pain in the abdomen, fever, skin discoloration, nausea and vomiting. These symptoms epigastric hernia rare must be reported to the doctor shortly after the event, as they may indicate a complication of epigastric hernia. In fact, a hernia accompanied by these symptoms is usually considered a medical emergency.

Epigastric hernia complications
An epigastric hernia is usually considered a medical emergency and treatment (surgery) may be deferred until the child is old enough to tolerate it. Unlike other types of hernia, epigastric hernia will not heal by itself and will require surgery.
Epigastric hernia can be a medical emergency when it becomes strangulated. This interrupt occurs when blood flow to the herniated herniated tissue. Strangulated hernia symptoms include red or purple coloration of the skin swollen and sometimes severe pain, diarrhea, nausea and vomiting.
Strangulated hernia is not common, so the symptoms of nausea and vomiting are the most common signs that the patient is experiencing a complication of epigastric hernia.

Treatment
The only treatment is the epigastric hernia surgery. Epigastric hernia surgery is typically performed under general anesthesia and can be performed outpatient. Special attention should be given to preparing children (most patients are children) for this intervention. The surgery is performed by a pediatric surgeon or a specialist surgeon in pediatric colorectal surgery.
Once anesthesia is done, the surgeon will make an incision on both sides each of hernia. In one incision a laparoscope is inserted and the incision cealalalta used other surgical instruments. The surgeon will then isolate the abdominal tissue to push the abdominal muscle wall. This tissue is called the hernial sac. Replace physician hernial sac in normal position and begin to repair the muscle defect.
If muscle defect is small, it can be remedied by suturing. Sutures will be permanent and will prevent the return of hernia. For larger defects, the surgeon will opt for repair by suture. In this case, it will use a special place to cover the hole.
This special place will be permanent and prevent the return of the hernia. Use the correct place for large hernias are a standard treatment, but it may not be appropriate if the patient’s medical history or currently rejecting surgical implants or other conditions that prevent their use.
After herniated portion was sutured and was applied post surgery, laparoscopic and other medical instruments can be removed and the incision closed. The incisions can be closed in several ways: by stitching with surgical thread (which will be removed in a subsequent medical visit), with a special glue that is used to close the incisions smaller than or special bandages.

Recovery
Normally, the risk of postoperative complications is less than 2%. In some cases, you may develop bleeding and mild swelling around the incision area. There is a small risk of infection of the incision, in which case antibiotics will be given.
Most patients with epigastric hernia can return to normal activity within 2-4 weeks after surgery. The abdomen is still fragile, especially in the first week after surgery.
Meanwhile, the incision should be protected during activities that increase abdominal pressure. This can be done by applying firm pressure, but mild incision area. The patient recovers incision should protect when:

  • move from lying down to sitting position or sitting position in vertical position
  • sneezes or coughs
  • crying – especially if the baby’s face turns red
  • can flex their abdomen during defecation
  • is vomiting.

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