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Epigastric Hernia

What is Epigastric Hernia?


The epigastric hernia appears in the midline, above the umbilicus. It affects more men than women with a ratio of 3: 1 and its incidence is less than 1% in the adult population.

Epigastric hernia is favored by intense and constant exertion, obesity or by diseases that increase intra-abdominal pressure such as chronic cough, constipation, difficulty urinating and repeated pregnancies.

Epigastric hernia is an increase in volume or tumor that appears in some area of ​​the midline above the navel, generally asymptomatic, although on rare occasions pain may appear at the site of the hernia when carrying out moderate or intense effort.

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Diagnosis of Epigastric Hernia


The diagnosis of epigastric hernia is made by the hernia surgeon by exploration. On rare occasions, auxiliary diagnostic studies such as ultrasound or computerized axial tomography will be needed.

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Treatment of Epigastric Hernia


The treatment of epigastric hernia is surgical and should be done as soon as it is identified since it always grows with the passage of time and the possibility of complications increases day by day.

Epigastric hernias can be operated with traditional techniques called "open surgeries", either by suturing the hernial orifice or applying reinforcing plastic mesh, but they can also be operated with a laparoscopic technique in which reinforcing plastic mesh is always applied inside the wall. abdominal.

Laparoscopic surgery has become very popular and is offering better postoperative results. The chances that an epigastric hernia that has already been operated on will reappear are very low if modern surgical techniques are used applying plastic hernia reinforcement mesh. I emphasize that the final result of these surgeries will be optimal if they are performed by a surgeon who is expert in the surgical management of epigastric hernias of the abdomen.


Complications of Epigastric Hernias are:


a) Imprisonment, when any structure or organ of the abdomen protrudes or "comes out" through the hernia orifice and is definitively established without being able to return to its place through external maneuvers. In most cases, what protrudes is the fatty cell tissue in such a way that it can be confused with a lipoma (a tumor of fatty tissue).

b) Strangulation, when these structures mentioned are "hanged" by the hernia orifice causing them lack of circulation and the consequent death of the trapped organ.

Treatment of epigastric hernia is always surgical. Open or laparoscopic techniques can be performed. The open ones with or without application of plastic meshes (prostheses), according to the criteria of the hernia surgeon. Laparoscopic techniques (minimally invasive surgery or "laser surgery") with mesh application in internal position. Both techniques have very good results as they reduce postoperative pain, disability time, the use of analgesics and the possibility of a recurrence of the hernia in the future.

The risks of these surgeries are minimal as well as the possibility of postoperative complications.

Recovery from epigastric hernia surgery consists of one day of hospital stay and 5 to 7 days of relative rest. You will be able to return to work on the eighth day.

It is up to the hernia surgeon to decide which procedure is best for each patient.

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