Epigastric hernia

Fabian Dupont is a freelance writer in the medical department. The human medicine specialist is already doing scientific work in Belgium, Spain, Rwanda, the USA, Great Britain, South Africa, New Zealand and Switzerland, among others. The focus of his doctoral thesis was tropical neurology, but his special interest is international public health and the comprehensible communication of medical facts.

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An epigastric hernia is also called an abdominal wall hernia. It describes a bulge in the abdominal wall between the navel and breastbone. The contents of the abdominal cavity pass through a weak point in the abdominal wall. In the beginning this can only be felt when the abdomen is tense, later intestines can also get into the hernial sac and become trapped there. This is a life-threatening emergency that needs to be operated on as quickly as possible. Read more about the symptoms, diagnosis and treatment of epigastric hernia here.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. K43

Epigastric hernia: description

Doctors speak of a hernia or abdominal wall rupture when the abdominal wall bulges outwards at a weak point in the abdominal wall and forms a so-called hernial sac. Almost one percent of all Germans suffer a hernia every year - 200,000 of them have to be operated on to avoid complications. Compared to other hernias, epigastric hernias are rather rare with a share of five percent. Men are three times more likely to be affected than women.

A hernia can either be congenital or appear in the course of life. In children, these hernias are often linked to embryonic development. If the baby's testicle has not yet fully slid into the testicle, this usually happens in the first year of life. This leaves an opening between the testicle and the abdomen through which the testicle can migrate. Organs can slip into this connection and this is called an inguinal hernia.

The epigastric hernia occurs in children and adults, typically between the sternum and belly button - sometimes in several places at the same time. What is important is the difference to diastasis rectus: Here, the divergence of the straight abdominal muscles (six-pack) results in an even elevation of the midline (linea alba) between the navel and the sternum. By definition, diastasis rectus is not referred to as a hernia, as there is no hernial sac in which the viscera can get caught. There is no danger here, and an operation primarily aims to achieve 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. Mostly chronic pressure problems in the upper abdomen, which can increase when standing up, sneezing or when defecating, are typical symptoms of an abdominal wall rupture. Symptoms such as sudden pain in the hernia region indicate that abdominal organs are trapped in the hernial sac - this can interrupt the blood supply to the organ. In this case, you should urgently see a doctor. Nausea and vomiting are other typical complaints.

Epigastric hernia: causes and risk factors

Although some children are born with a diagnosis of epigastric hernia, it is more likely to occur in older people. Because the increasing weakness of the connective tissue in old age promotes hernia problems. Even in overweight people, the connective tissue is often weakened, so that more tears and hernias occur. High pressure within the abdomen caused by chronic constipation or heavy lifting also encourage hernia to develop. Family history is an important risk factor. If the family, parents, siblings or grandparents are known to have a hernia, there is an increased risk of suffering an abdominal wall rupture in the course of their life.

Epigastric hernia: examinations and diagnosis

If you suspect you have an epigastric hernia, it is best to see your GP or a gastroenterologist. He will first seek a conversation with you (anamnesis). This is followed by a physical exam. The doctor asks the patient to cough or tense the stomach in order to feel changes. Because if the abdominal pressure increases, a bulge can usually be felt. This hernial sac, which bulges under pressure, confirms the doctor's diagnosis of an abdominal wall hernia.

Epigastric hernia: treatment

The epigastric hernia has only a low risk of entrapment of the abdominal organs, so therapy is usually only recommended if there are symptoms. In this case, the surgeon surgically removes the hernial sac and relocates the contents of the hernial sac back into the abdomen. By storing plastic nets, the doctor can strengthen the abdominal wall in order to prevent the recurrence of a hernial sac.

Epigastric hernia: disease course and prognosis

The epigastric hernia is a harmless condition. As a rule, the patients have no symptoms for many years. If complications arise, surgery is necessary. Basically, it makes sense to avoid risk factors such as excessive weight or heavy lifting.

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