Epigastric hernia is a condition when the internal organs of the stomach protrude in the midline of the abdomen, between the navel and the sternum. Epigastric hernias can happen to anyone, both adults and newborns.
Small epigastric hernias generally do not cause symptoms and do not need to be treated. However, if it is large, surgery needs to be done to prevent complications, such as intestinal obstruction.
Epigastric Hernia Causes and Risk Factors
Epigastric hernias in newborns are caused by congenital abnormalities in the abdominal muscles. Whereas in adults, epigastric hernias occur when the stomach muscles weaken. Both of these conditions cause the abdominal muscles to be unable to hold the organs in the abdomen so that they protrude.
There are several factors that can increase the risk of weakening the abdominal muscles, namely:
- Injury due to accident or impact of surgery
- Chronic cough
- Family history of hernias
Epigastric hernias can also be triggered by increased pressure in the stomach, for example due to:
- Is pregnant
- Are overweight or obese
- Suffering from chronic coughing or sneezing
- Suffering from diverticulitis
- Experiencing constipation (constipation)
- Fluid buildup in the abdomen ( ascites )
- Lifting heavy weights
Epigastric Hernia Symptoms
Just like other types of hernias, epigastric hernias are also characterized by the appearance of a lump. The size of the lump in each patient can be different, depending on the severity of the condition.
In some cases, the lump can be easily seen. However, in other cases, the lump can only be seen when the patient laughs, sneezes, coughs or strains.
Apart from a lump, sufferers of epigastric hernias can also experience additional symptoms, such as:
- Inflammation of the lump
- Pain or burning sensation in the lump
- Pain when coughing, lifting weights, or bending
When to see a doctor
Check with your doctor if you experience the above symptoms. Early examination is needed so that it can be treated immediately so that the worsening of the condition can be prevented.
Immediately consult a doctor if your symptoms are accompanied by vomiting and fever, or if the hernia lump starts to turn red, purple, or black.
Diagnosis of Epigastric Hernia
The doctor will ask questions and answers about the patient's symptoms, medical history, and history of injuries. The doctor will also ask about the surgery the patient has undergone.
Next, the doctor will do a physical examination of the area where the lump is. If the lump is still small, the doctor will ask the patient to bend over, cough, or strain, so that the lump can be seen more clearly. After that, the doctor may suggest a complete blood count, electrolyte levels, and urine tests.
To confirm the diagnosis, the doctor can perform a scan to see the condition of the patient's internal organs, such as:
- CT Scan
Epigastric Hernia Treatment
Epigastric hernias cannot heal on their own. This condition can only be treated with surgery.
Operations to treat hernias can be open surgery, laparoscopic, or robotic surgery. The choice of the type of surgery will be adjusted to the severity of the hernia experienced by the patient. Although the techniques are different, all of these operations aim to return the protruding organ to its original position.
The following is an explanation of surgery to treat epigastric hernias:
The surgeon will make a sizeable incision in the epigastric area and return the organs to their original position. After that, the hole in the stomach will be closed with a synthetic mesh ( mesh ), then the incision on the abdominal wall will be sutured.
Just like open surgery, laparoscopic surgery also uses a synthetic mesh to cover the abdominal muscles after the exiting organs are returned to their original position. The difference is, this operation only requires a small incision as a way to enter the laparoscope.
Just like in laparoscopic surgery, robotic surgery also uses small incisions and a laparoscope. The difference is, the doctor will control the robot arm using a computer so it doesn't touch the patient directly.
The three operations above use general anesthesia. Therefore, first consult with your doctor if you have a history of allergies to anesthetic drugs.
Epigastric Hernia Complications
If left untreated, an epigastric hernia can cause several complications, such as:
- Bowel blockage (bowel obstruction )
- The intestine is pinched and difficult to return to its normal position (incarcerated hernia)
- The intestine is pinched and does not get blood flow so that it can cause gangrene (strangulated hernia)
- Enlargement of the hernia making it difficult to repair
Not only because of the disease, complications can also occur due to hernia surgery, such as:
- Surgical wound infection
- Infection in synthetic nets
- Blood clotting
Prevention of Epigastric Hernia
There are a number of measures that can be taken to reduce the risk of an epigastric hernia, namely:
- Maintain body weight to remain ideal
- Increase fiber intake from vegetables and fruits
- Avoid lifting weights that are too heavy, or be careful if forced to do so
- Quit smoking to prevent chronic cough
- Lose weight , if suffering from obesity