Epigastric hernia

What is an epigastric hernia?

Epigastric hernias are lumps or bulges that show up in the upper part of the belly between the breastbone and the belly button. Epigastric hernias are typically very small. They are caused by a small hole in the muscle of the belly wall. A small amount of fat can fit through the hole causing the lump or bulge.

What causes epigastric hernias?

Most epigastric hernias are present at birth. They become noticeable when a piece of fat protrudes through them.

How is it diagnosed?

Epigastric hernias are rarely painful. They are often more noticeable when the child stands. They can almost always be diagnosed with physical review by a medical provider. Rarely, imaging such as ultrasound is needed to make the diagnosis.

How should I care for my child?

No special care is needed for an epigastric hernia. Your child can join in in all normal activities. It is not necessary to put anything over the hernia or do anything to try to keep it in or make it smaller.

When should I call the clinic?

Call the clinic if your child feels pain in the hernia.

When should I go to the ER?

Go to the ER if your child shows any of the following signs, which could mean that the intestine is trapped through the abdominal wall opening:

• The skin over the hernia becomes swollen or tender
• The skin over the hernia becomes red or discolored
• The epigastric hernia looks swollen and your child develops repeated vomiting

What is epigastric hernia repair?

Epigastric hernia repair is the surgery to fix an epigastric hernia. It is a same-day surgery meaning your child will go home on the same day as the surgery. The surgery requires anesthesia. During the surgery a small cut is made in the skin over the hernia. The hole in the muscle is fixed with stitches. The skin is then either sewn or glued closed.

• Benefits: Closing the epigastric hernia decreases the chance of the hernia getting bigger as the child grows.
• Risks: Bleeding, infection, fluid under the incision.
• Long term outcomes: Children with epigastric hernias do well. Recurrence of the hernia is rare.

What can I expect after the surgery?

• Diet: Most patients are able to eat a normal diet.
• Activity: There are no activity restrictions after the surgery. Your child may return to normal activities as they tolerate.
• Wound care: Your child might have a bandage over the cut in their skin for a few days after the surgery that you will remove at home. Your child can shower within a couple days of surgery but you may want to wait 5-7 days after surgery before soaking the wound.
• Medicines: Medication for pain such as acetaminophen (Tylenol®) or ibuprofen (Motrin® or Advil®) or something like a narcotic may be needed to help with pain for a few days after surgery.
• Return to school/daycare: Your child may return to school or daycare when you feel it is appropriate.
• When to call the doctor: Fevers over 101 °F, wound redness, and/or drainage might indicate an infection. You should contact your child’s surgeon if your child develops these after surgery.
• Follow-up care: Follow-up with your child’s surgeon as needed for questions/concerns. You can call (612) 813-8000 to schedule an appointment.

Questions?

This information is not specific to your child but provides general information. If you have any questions, please call your clinic.

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