Epigastric hernia is a type of hernia that occurs in the middle part of the abdomen which is located between the navel and the chest. Hernia is a condition in which the organs in the abdomen protrude from their proper position. Weakening of the protective layer that keeps organs in position is the cause of epigastric hernias.
Epigastric hernia is characterized by the appearance of a lump. However, patients may also experience other symptoms, such as pain or a burning sensation in the problem area. An epigastric hernia that does not get treatment has the potential to cause complications in the form of an enlarged lump and intestinal blockage.
Causes of Epigastric Hernia
An epigastric hernia is the result of a weakening of the protective layer (muscle or tissue) that keeps the abdominal organs in position. In this case, there are several factors that can cause the weakening of the protective layer, including:
- Age increase
- Injury due to accident or impact of surgery
- Chronic cough
Increased pressure in the abdomen also triggers an epigastric hernia. Increased pressure in the abdomen can be caused by various factors, such as:
- Weight gain
- Persistent cough or sneeze
- Constipation (pressure in the stomach increases when a person strains)
- Fluid in the abdomen (ascites)
- Lifting heavy weights
Symptoms of an Epigastric Hernia
Just like other types of hernia, epigastric hernia is also characterized by the appearance of a lump. The size of the lump in each person is different, depending on the severity of the condition.
The lump is located in the epigastric, which is the area of the middle abdomen that is above the belly button or below the breastbone. In some cases, the lump can be easily seen. But in other cases, the lump can only be seen when the patient laughs, sneezes, coughs, or in other conditions that can increase pressure in the stomach.
In addition, people with epigastric hernias may also experience additional symptoms, such as:
- Inflammation of the lump.
- Pain or a burning sensation in the lump.
- Pain when coughing, lifting weights, or just bending over.
Epigastric Hernia Diagnosis
The initial diagnosis is made by physical examination, risk factors, medical history, and the patient's overall health condition. On physical examination, when the lump is still small, the doctor will ask the patient to bend over, cough, or sneeze so that the lump can be seen more clearly.
To confirm the condition suffered, the doctor can continue the examination by running a scan test. The tests used generally serve to produce images of the condition of the patient's internal organs. Some of these tests include:
- CT Scan
Epigastric Hernia Treatment
Epigastric hernias don't get better on their own. This condition can only be treated with surgery. Operations performed to treat epigastric hernias are divided into two, namely open surgery and laparoscopic surgery. Although different, this operation aims to restore the organ that came out to its original position.
- Open operation. The surgeon will make a large incision in the epigastric area. When the process of returning the organ to its original position is complete, the perforated protective layer (muscle or tissue) will be covered with a synthetic mesh (mesh). Then, the incision on the abdominal wall that has been made previously will be glued together with staples or special glue.
- Hernia surgery by laparoscopy. Just like open surgery, laparoscopic surgery also uses a synthetic mesh to cover the protective layer after the organ that has been expelled is returned to its original position. However, this operation requires only 3 small incisions (1.5 cm) which are used to provide the entrance for the laparoscope, a special instrument that contains a light and a camera.
Both operations use anesthesia. Consult further with the doctor if the patient has a history of allergies to anesthetics. Also discuss the type of operation that suits the conditions. Open surgery and laparoscopic surgery have their advantages and disadvantages.
Epigastric Hernia Complications
Epigastric hernias that do not get treatment have the potential to cause complications, such as:
- Intestinal obstruction.
- Increased pain.
- Enlargement of the hernia, making it difficult to repair.
Complications can also occur as a result of the surgery performed. Some of them are:
- Surgical wound infection.
- Infection in synthetic nets.
- Blood clotting.
Epigastric Hernia Prevention
Several efforts can be made to reduce the risk of epigastric hernia, namely:
- Avoid smoking.
- Eat high-fiber foods.
- Maintain weight.
- Be careful when lifting weights, or avoid them as much as possible.