epigastric hernia

Etiology

• congenitally weakend linea alba from a lack of decussating midline fibers
• increased intra-abdominal pressure
• abdominal wall muscle weakness
• chronic abdominal wall strain

Epidemiology

• 3-5% of general population
• most commonly occurs in middle-aged individuals
• congenital epigastric hernias uncommon
• male:female ratio is 3:1
• 20% have multiple hernias

Pathology

• defects in the abdominal wall midline between the umbilicus & the xiphoid process
• often < 1 cm in diameter
• frequently peritoneal fat incarcerated in hernia
• peritoneum & bowel infrequently herniate, thus bowel incarceration & strangulation rare

Management

• surgery
  • generally under local anesthesia
  • must be opened & enlarged to reduce incarcerated peritoneal fat
  • recurrences uncommon

More general terms

• abdominal wall hernia (ventral hernia)