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Small Epigastric Hernia: 8 Key Facts

Last Updated on November 26, 2025 by Bilal Hasdemir

Small Epigastric Hernia: 8 Key Facts
Small Epigastric Hernia: 8 Key Facts 4

Discover small epigastric hernia causes, risks, and surgical treatment options for quick recovery.

An epigastric hernia happens when tissue bulges through a weak spot in the belly. This weak spot is between the breastbone and belly button. You might see a lump or bulge above the belly button or below the sternum. Knowing about the risks and how to treat an epigastric hernia is key.

Liv Hospital’s skilled surgeons focus on the patient. They make sure diagnosis is safe and treatment is advanced for small epigastric hernias. By learning about the location and risks, patients can make better choices for their care.

Key Takeaways

  • An epigastric hernia is a protrusion of tissue through a weak spot in the abdominal wall.
  • It typically occurs between the breastbone and belly button.
  • A lump or bulge above the belly button can be a sign of an epigastric hernia.
  • Liv Hospital offers expert diagnosis and surgical solutions.
  • Understanding the risks and treatment options is key for effective management.

What Is a Small Epigastric Hernia?

Small Epigastric Hernia: 8 Key Facts
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A small epigastric hernia is a hernia that happens between the navel and the breastbone. It’s when fatty tissue or part of the intestine bulges through a weak spot in the belly wall. This is known as an epigastric hernia.

Definition and Basic Anatomy

An epigastric hernia happens in the area between the navel and the breastbone. These hernias are often called fatty hernias because they usually have fat, not bowel. The belly wall has layers of muscle and fascia.

A weak spot in this wall lets fatty tissue or intestine bulge out, making a hernia.

How Common Are Epigastric Hernias?

Epigastric hernias are not as common as other hernias. They make up a small part of all belly hernias. Here are some key facts about them:

  • They happen more in men than in women.
  • They can happen at any age, but mostly in adults.
  • The exact cause is often unknown, but it’s thought to be due to weak spots in the belly wall.

Knowing how common and what epigastric hernias are can help people understand their condition better. It also helps them know what treatment they need.

Location and Identification of Epigastric Hernias

Small Epigastric Hernia: 8 Key Facts
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A small epigastric hernia shows up as a lump or bulge between the breastbone and the belly button. Knowing where and how these hernias look is key to spotting them.

The Epigastric Region Explained

The epigastric region is the space between the breastbone (sternum) and the navel (belly button). It’s a common spot for epigastric hernias. This area is part of the abdominal region, making hernias here stand out because of the thin tissue.

Recognizing a Lump Below Sternum or Bump Above Belly Button

Epigastric hernias appear as a lump below the sternum or a bump above the belly button. These lumps are small and might be more obvious when you cough, strain, or stand up. Sometimes, you can push the lump back into your abdomen.

CharacteristicsEpigastric HerniaOther Abdominal Hernias
LocationBetween sternum and navelVarious locations including groin and navel
PresentationLump or bulgeLump or bulge, sometimes with different characteristics
Common CausesCongenital or acquired weaknessWeakness in abdominal wall, strain

Difference Between Epigastric and Other Abdominal Hernias

While all epigastric hernias are abdominal hernias, not all abdominal hernias are epigastric. The main difference is their location and how they look. Epigastric hernias are found between the sternum and the navel, unlike other hernias like inguinal or umbilical ones.

Knowing these differences helps people spot epigastric hernias. This way, they can get the right medical care and treatment.

Understanding “Fatty Hernias” in the Epigastric Region

Epigastric hernias are often called ‘fatty hernias’ because they mainly have fatty tissue. This is key to understanding these hernias and how to treat them.

What Makes a Hernia “Fatty”?

A hernia is called “fatty” if it has preperitoneal fat. This fat is between the abdominal muscles and the peritoneum. Fatty hernias happen in the area between the navel and the sternum. The fat in these hernias affects symptoms and treatment.

  • Contain preperitoneal fat
  • Occur in the epigastric region
  • Influence symptoms and treatment

Fat vs. Bowel Protrusion: Key Differences

The main difference between fatty hernias and those with bowel protrusion is their content. Fatty hernias have fat, while bowel hernias have part of the intestine. This difference is important because it changes how severe symptoms are, the risk of complications, and the treatment needed. For example, bowel hernias are more likely to have serious problems like incarceration or strangulation.

  1. Content: Fat vs. bowel
  2. Symptoms: Varying severity
  3. Complications: Different risks
  4. Treatment: Different approaches

Causes and Risk Factors of Hernias by the Sternum

It’s important to know what causes epigastric hernias to prevent and catch them early. Most small hernias don’t cause big problems right away. But, they can lead to serious issues. The exact reason for hernias is often a mystery. But, it’s a mix of things that make the abdominal wall weak.

Congenital Weakness in the Abdominal Wall

Being born with weak spots in the abdominal wall is a main reason for hernias. Some people are born with these weak spots. They happen when the abdominal wall doesn’t close fully during pregnancy.

Lifestyle and Environmental Risk Factors

Lifestyle and environment also affect hernia risk. Being overweight, smoking, and eating poorly can make the abdominal wall weak. Also, activities that put a lot of pressure on the belly, like heavy lifting, can increase the risk.

Activities That Increase Abdominal Pressure

Doing activities that put pressure on the belly can lead to hernias. This includes lifting heavy things, bending, or straining during bowel movements. Knowing these risks can help prevent them.

Risk FactorDescriptionPreventive Measure
Congenital WeaknessWeakness in the abdominal wall present at birthMonitoring for symptoms
ObesityExcess body weight putting strain on the abdominal wallMaintaining a healthy weight
Heavy LiftingActivities that increase abdominal pressureLifting correctly, avoiding heavy lifting

Symptoms and Signs of a Small Epigastric Hernia

An epigastric hernia can show up as a painless lump or a painful issue. Symptoms often get worse when you do activities that put more pressure on your belly.

Painless vs. Painful Presentations

Small epigastric hernias are usually painless and show up as a lump or bulge. But, some people might feel pain or discomfort, mainly if the hernia gets stuck or cut off blood flow.

Painful presentations are less common but can mean a serious issue. It’s key to watch for any changes in the hernia and get medical help if pain starts.

When to Be Concerned About a Knot Above Belly Button

A knot or bulge above the belly button might mean an epigastric hernia. While often not serious, it’s important to worry if you see:

  • Increasing pain or tenderness around the hernia
  • Redness or swelling
  • Nausea or vomiting
  • Fever

If you notice these symptoms, get medical help right away.

How Symptoms Change With Activity and Strain

Symptoms of an epigastric hernia can change with what you do. For example, lifting heavy things or straining during bowel movements can make the hernia more noticeable or painful.

ActivityEffect on Symptoms
Lifting heavy objectsIncreased pain or discomfort
Straining during bowel movementsExacerbated symptoms
Coughing or sneezingTemporary increase in discomfort

Knowing how activities affect your symptoms can help manage your condition. It also helps figure out when to get medical help.

Is an Epigastric Hernia Dangerous? Possible Complications

Epigastric hernias, though small, can cause serious problems if not treated. They happen in the area between the navel and the sternum. Even if they don’t show symptoms at first, there are risks that need attention.

Understanding Incarceration and Strangulation

Incarceration happens when the hernia’s contents get stuck and can’t go back inside. This can lead to strangulation, a serious issue where the intestine’s blood supply is cut off. Strangulation is a medical emergency that needs quick action to avoid tissue death and other serious problems.

It’s key to watch epigastric hernias closely because of the risk of incarceration and strangulation. Knowing the signs of trouble, like severe pain, nausea, and vomiting, is important.

Warning Signs That Require Immediate Medical Attention

Certain symptoms mean an epigastric hernia has turned serious and needs quick medical check-up. These include:

  • Severe pain at the hernia site
  • Can’t push the hernia back in
  • Nausea and vomiting
  • Fever
  • A tender or red lump at the hernia site

If you see these signs, getting medical help fast is vital to avoid serious issues.

Long-term Risks of Untreated Hernias Below the Sternum

Not treating an epigastric hernia can lead to long-term problems. These include chronic pain, higher risk of incarceration and strangulation, and the hernia getting bigger. Also, an untreated hernia can really affect your quality of life, causing discomfort and worry.

In summary, even though epigastric hernias might seem harmless at first, they can have serious complications like incarceration and strangulation. Knowing the warning signs and understanding the long-term risks are key to managing these hernias well.

Diagnosis and Medical Assessment

If you have a painful knot above your belly button or a bulge under your sternum, it might be an epigastric hernia. Doctors use a mix of clinical checks and imaging studies to find out. This helps them see if you have a hernia and how big it is.

Physical Examination Techniques

Doctors start by checking your belly with a physical exam. They look for any bulges or odd feelings. They might press on your belly to see how big and sore the hernia is.

Imaging Studies for Confirming Epigastric Hernias

At times, doctors might ask for ultrasound or CT scans to be sure. These tests give more details about the hernia. They help doctors figure out the best way to treat it.

Imaging StudyUse in Epigastric Hernia Diagnosis
UltrasoundNon-invasive, useful for initial assessment
CT ScanProvides detailed images, helpful for complex cases

Differential Diagnosis: Other Causes of Bulges Under the Sternum

Doctors also look at other reasons for bulges under the sternum, like lipomas. A detailed check helps them find the right cause. This ensures they give the right treatment.

Epigastric Hernia Surgery and Treatment Options

Surgery is often needed for epigastric hernias. This is true for hernias that are getting bigger or causing symptoms. The decision to have surgery depends on the hernia’s size, symptoms, and the patient’s health.

When Is Surgery Necessary for Abdominal Hernias Above the Navel?

Surgery is needed for epigastric hernias that hurt a lot or cause serious problems. Small hernias without symptoms might be watched closely. But, bigger or painful hernias usually need surgery.

Surgical Approaches: Open vs. Laparoscopic Repair

There are two main ways to fix epigastric hernias: open and laparoscopic. Open repair uses one big cut to fix the hernia. Laparoscopic repair uses small cuts and a camera to do the job. Laparoscopic surgery usually means less pain and a faster recovery.

What to Expect During Epigastric Hernia Operation

During surgery, the surgeon will find the hernia and fix it. They will push back any bulging parts and strengthen the area. This is often done with mesh to prevent future hernias.

Mesh vs. Non-mesh Repair Techniques

Mesh is often used to prevent hernias from coming back. Mesh repair uses a synthetic or biological mesh. Non-mesh repair uses stitches for small hernias. The choice depends on the hernia size, patient health, and the surgeon’s preference.

Surgical ApproachDescriptionRecovery Time
Open RepairSingle incision over the herniaSeveral weeks
Laparoscopic RepairMultiple small incisions1-2 weeks

Recovery and Long-Term Outlook

Recovery from epigastric hernia surgery is usually quick. But, it’s key to stick to a post-op plan for the best results. The recovery time can differ based on the surgery type and personal factors.

Typical Recovery Timeline After Surgery

The recovery time for epigastric hernia surgery can be a few weeks to a couple of months. Most people can get back to normal in 2-4 weeks. But, they should avoid heavy lifting and hard activities for up to 6 weeks.

  • Immediate Recovery (0-2 weeks): Rest and limited activity
  • Gradual Return to Normal Activities (2-4 weeks): Gradually increase activity levels
  • Full Recovery (4-6 weeks): Resume heavy lifting and strenuous activities

Epigastric Hernia Scar: Appearance and Care

The scar’s look can change based on the surgery method. It’s important to take good care of the scar for better healing and to avoid problems.

Tips for Scar Care:

  1. Keep the incision site clean and dry
  2. Follow the surgeon’s instructions for dressing changes
  3. Avoid direct sun exposure to the scar

Preventing Recurrence and Future Hernias

To prevent future hernias, you need to make lifestyle changes and follow post-op care. Keeping a healthy weight, avoiding heavy lifting, and managing chronic coughing or constipation can help a lot.

Key Strategies:

  • Maintain a healthy weight through diet and exercise
  • Avoid heavy lifting and bending
  • Manage conditions that cause chronic coughing or straining during bowel movements

Conclusion

Small epigastric hernias happen in the belly area above the navel. They need quick attention to avoid serious problems. These hernias can hurt a lot and cause big health issues if not treated.

We’ve looked at what epigastric hernias are, why they happen, their symptoms, how to find out if you have one, and how to treat them. It’s important to know the dangers of these hernias. Problems like incarceration and strangulation can be very dangerous.

Surgery is often needed to fix epigastric hernias. There are different ways to do this, like open or laparoscopic repair. Knowing about the risks and how to treat small epigastric hernias helps manage them well.

Knowing the signs of hernias above the navel helps people get help fast. This can prevent serious health problems. Treating epigastric hernias well needs a good understanding of these conditions.

FAQ


What is an epigastric hernia?

An epigastric hernia is a bulge in the belly area. It happens when fatty tissue or intestine pushes through a weak spot in the stomach wall.

Where is the epigastric region located?

The epigastric region is in the upper middle of the belly. It’s between the navel and the sternum.

What are the symptoms of a small epigastric hernia?

Symptoms of a small epigastric hernia can be a lump or bulge. It might be painless or painful. The symptoms can change with movement and strain.

Is an epigastric hernia dangerous?

Yes, an epigastric hernia can be dangerous. If it gets trapped or the blood supply is cut off, it’s an emergency.

What is a fatty hernia?

A fatty hernia is when fatty tissue bulges through a weak spot in the stomach wall.

How is an epigastric hernia diagnosed?

Doctors usually diagnose an epigastric hernia by feeling the belly. They might also use ultrasound or CT scans to confirm it.

What are the treatment options for an epigastric hernia?

Treatment options include watching it, surgery, or making lifestyle changes. Surgery is often needed to fix the hernia and prevent problems.

What is the difference between open and laparoscopic surgery for epigastric hernia repair?

Open surgery uses a big cut to reach the hernia. Laparoscopic surgery uses small cuts and a camera. Laparoscopic surgery usually means less pain and quicker recovery.

How long does it take to recover from epigastric hernia surgery?

Recovery from epigastric hernia surgery takes several weeks. Patients should avoid heavy lifting and hard activities during this time.

Can an epigastric hernia recur after surgery?

Yes, an epigastric hernia can come back after surgery. But, following the right surgical techniques and care can lower the risk.

How can I prevent an epigastric hernia?

To prevent an epigastric hernia, stay healthy, avoid heavy lifting, and manage chronic coughing or straining during bowel movements.

References

Huttinger, R. (2023). Spigelian hernia. In StatPearls. National Library of Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK538290/

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