Surgery Book

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Epigastric Hernia

Aka: Epigastric Hernia, Hypogastric hernia, Fatty Hernia of the Linea Alba
  1. See Also
    1. Hernia
    2. Inguinal Hernia
    3. Inguinal Hernia in Children
    4. Sports Hernia
    5. Inguinal Hernia
    6. Femoral Hernia
    7. Umbilical Hernia
    8. Paraumbilical Hernia
    9. Incisional Hernia
    10. Spigelian Hernia
    11. Diastasis Recti
    12. Hernia Reduction
  2. 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
  3. Symptoms
    1. Epigastric Pain
    2. Pulling sensation on leaning backward
  4. 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)
  5. Differential Diagnosis: Epigastric Incarcerated Hernia
    1. Peptic Ulcer Disease
    2. Biliary Colic
  6. 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
  7. 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

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
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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