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Epigastric Hernia

What is an epigastric hernia?

An epigastric hernia is a small defect, opening or weakness in the fibrous tissue of the midline abdomen between the umbilicus (belly button) and the xyphoid process (breast bone). It is caused by incomplete closure of the fibrous tissue of the abdomen during development. 

What does an epigastric hernia look like?

When your child cries, stools, strains or bears down a small bump will push out somewhere along the center of the abdomen. Usually the bump is filled with fluid or fat. As soon as the child relaxes, the bump will sink back into the abdomen. These hernias are generally asymptomatic, but sometimes patients will note a small, slightly uncomfortable lump in the abdomen. Risk of bowel incarceration or strangulation is negligible and not a concern in children. 

Does my child need surgery for this type of hernia?

This type of hernia will not close on its own and surgical repair is generally recommended. If not repaired, this type of hernia may enlarge or become painful and symptomatic in the future.

How is the hernia repaired?

A general anesthetic is used. It is very important for you and your surgeon to mark the exact site of the bump with a special marker before your child goes to sleep the day of surgery. A small incision is made in the abdomen just over the hernia. The hernia sac and fiber tissue layers are closed with sutures. The outer skin is then closed with skin glue and/or special surgical tapes called steri-strips.

How do we care for the incision?

You may keep a bandage over the incision as needed for the first week to protect it from rubbing on clothing if this is more comfortable for your child. Keep the incision dry for 48 hours and then your child may resume showers, shallow baths or sponge baths. Be sure to gently pat the incision dry after bathing and avoid rubbing. The incision should not be submerged in water and your child should not swim for 2 weeks. Once your child resumes normal bathing, the skin glue or tapes will begin to peel away and generally fall off on their own within 7-10 days.

What restrictions will my child have after the surgery?

Your child can return to normal activity or school generally by the next day but should avoid strenuous physical activity, gym class, organized sports and heavy lifting for 2-4 weeks. Your surgeon will base your child’s activity restrictions upon their age and activity level. 

Will my child have pain after surgery?

Most children do not have severe pain after an epigastric hernia repair. Most often over the counter pain relievers (Tylenol or Motrin) are adequate for pain control as needed afterwards for mild incisional discomfort. 

When should I contact the surgeon?

  • for redness, increased swelling, increased pain/tenderness around the incision
  • fever > 101 degrees F
  • any unusual drainage or foul odor from the incision 

Contact information and hours

Our office is open Monday through Friday from 8:00 a.m. - 5:00 p.m. Please call us with any questions or concerns in regards to your child's post-operative care. Our office number is 248-551-2400. After office hours and on weekends or holidays, your call will be directed to our on call surgeon thru our answering service.