An epigastric hernia, also known as an epigastric hernia or upper abdominal hernia, is an abdominal wall hernia located on the midline of the upper abdomen between the lower end of the sternum (xiphoid process) and the belly button. Here you will find further information and selected abdominal wall hernia specialists and centers.
The so-called linea alba is the vertical connective tissue suture in the middle of the abdomen. It runs between the belly button and the breastbone. The linea alba is formed by the fusion of the tendons of the lateral abdominal wall muscles.
In the case of an epigastric hernia, a gap develops in the abdominal wall along the linea alba (hernial orifice). Through this gap, parts of the abdominal cavity bulge outwards as hernia contents into a sac-like protrusion of the peritoneum (hernia sac). Connective and fatty tissue is usually affected and, in rare cases, parts of the small intestine.
Clearly visible linea alba in a slim woman © Mirrorstudio | AdobeStock
The epigastric hernia is therefore similar to other external hernias, such as
Epigastric hernias are significantly less common than inguinal hernias or umbilical hernias. It accounts for only around 1.6 to 3.6 percent of all abdominal wall hernias.
It mostly affects middle-aged people. Men and women suffer an epigastric hernia at roughly the same rate.
Those affected usually suffer from a congenital weakness of the connective tissue, which means that the abdominal wall is not as firm as it should be. An epigastric hernia develops when there is also increased intra-abdominal pressure along the midline of the abdomen.
An increase in intra-abdominal pressure can be caused by, among other things
can be caused.
In addition, these include
are also among the risk factors that can promote the development of an epigastric hernia.
Lifting heavy loads can promote the development of an epigastric hernia if the connective tissue is weak © Maria Fuchs | AdobeStock
An epigastric hernia usually manifests itself as a protrusion along the linea alba, which can be seen and/or felt from the outside.
The typical symptoms of an epigastric hernia also include severe and sudden pain in the upper abdomen. They are caused or intensified by an increase in internal abdominal pressure.
In some cases, a large epigastric hernia can lead to the entrapment of intestines in the hernial orifice. In addition to severe, persistent pain, nausea and vomiting may also occur.
An epigastric hernia is usually diagnosed as part of a detailed medical history and physical examination.
During the medical history interview, the patient is asked about their symptoms, living conditions and medical history.
During the physical examination, the doctor will palpate the patient's upper abdomen thoroughly (palpation). The doctor may be able to feel the hernial orifice and the bulging hernial sac and thus make a diagnosis of an epigastric hernia.
Depiction of an abdominal wall hernia © blueringmedia | AdobeStock
Following this, imaging examinations such as
can also be used. This enables the doctor to diagnose the epigastric hernia reliably and unequivocally or to rule out or confirm other diseases.
An epigastric hernia does not disappear on its own. The symptoms get worse over time and there is also a risk of intestines becoming trapped in the hernial orifice. An epigastric hernia should therefore always be treated surgically as part of hernia surgery.
Surgical treatment of an epigastric hernia includes
two surgical techniques are available.
The operation can be performed either minimally invasively or as part of an open procedure. Which surgical procedure is used depends on the size of the epigastric hernia and the extent of the symptoms.
