Epigastric Hernias

Question 1

What is an epigastric hernia?

Answer 1

Defects in the midline tissues of the linea Alba (it can be small or extensive)

Question 2

Clinical presentation

Answer 2

• they vary in size: up to large defects
• always placed in the midline, although when it’s large it may lie to one side
  Moderate risk of strangulation

Question 3

Diagnosis

Answer 3

By clinical presentation
If there is a concern that a palpable lump is a lipoma/subcutaneous tissue growth then a ct may usually confirm the diagnosis

Question 4

Treatment

Answer 4

Surgical repair is offered for symptomatic hernias/ high risk of complications

Question 5

Principles of repair

Answer 5

Identify edges of the hernial sac and reduce the hernia

Small defects are usually repaired by an overlapping sutured repair using non-absorbable suture (0 prolene ) without reinforcements

Larger defects/recurrent hernias may require mesh, usually polypropylene (prolene) which is usually placed on top of the fascia like layers