II. Pathophysiology

  1. Type of Ventral Hernia
  2. Consists of properitoneal fat (rarely peritoneal sac)
  3. Location
    1. Occurs through linea alba (midline)
    2. Occurs below xiphoid process and above Umbilicus

III. Symptoms

  1. Epigastric Pain
  2. Pulling sensation on leaning backward

IV. Signs

  1. Difficult to detect in obese patients
  2. Frequently presents as Incarcerated Hernias of preperitoneal fat
    1. Bowel incarceration or strangulation is rare
  3. Examine patient in standing position
    1. Run finger down course of linea alba
    2. Detects small midline Nodule
    3. Hernias are typically small (<1 cm)

V. Differential Diagnosis: Epigastric Incarcerated Hernia

VI. Management: Surgery

  1. Suture closure of defect
  2. Multiple Epigastric Hernia defects often exist
    1. Adequate linea alba exposure required
    2. Surgeons explore for occult Hernias

VII. References

  1. Goroll (2000) Primary Care Medicine, p. 431-433
  2. Degowin (1987) Diagnostic Examination, p. 489-96
  3. Stevens (2013) Crit Dec Emerg Med 27(9): 2
  4. Townsend (2001) Sabiston Surgery, Saunders, p. 797

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Ontology: Epigastric hernia (C0019287)

Concepts Anatomical Abnormality (T190)
ICD10 K43.9
SnomedCT 12217001, 236034007, 196900007, 196876001, 196895008, 289260002
English Epigastric hernia NOS, epigastric hernia, epigastric hernia (diagnosis), Epigastric hernia, hernia epigastric, epigastric hernias, abdomen hernia epigastric, abdomen hernia epigastric (physical finding), Epigastric hernia NOS (disorder), Fatty hernia of linea alba, Epigastric hernia (disorder), Epigastric hernia (disorder) [Ambiguous]
Dutch hernia epigastrica
French Hernie épigastrique
German Hernia epigastrica
Italian Ernia epigastrica
Portuguese Hérnia epigástrica
Spanish Hernia epigástrica, hernia epigástrica, SAI, hernia epigástrica, SAI (trastorno), hernia epigástrica (concepto no activo), hernia epigástrica (trastorno), hernia epigástrica
Japanese 心窩部ヘルニア, シンカブヘルニア
Czech Epigastrická kýla
Hungarian Epigastrialis sérv