Epigastric hernias are typically small and do not cause symptoms. However, larger ones or ones that appear to be growing larger should be surgically repaired by skilled surgeons to avoid complications.

What is an Epigastric Hernia?

An epigastric hernia has some qualities that are different from other hernia types. While all hernias occur when a weakening in your abdominal wall allows tissue to push through, epigastric hernias typically involve fat pushing through the abdominal wall. Most occur around the navel and are often confused with umbilical hernias. They can occur anywhere from the breast bone to the navel, however. These hernias may be called ventral hernias by your doctor.  

This type of hernia is usually small. It is possible to have more than one at the same time.

Causes of an Epigastric Hernia

Some epigastric hernias are present at birth. Some seem to appear and disappear, which is known as a reducible hernia.

Obesity and pregnancy both put pressure on the abdominal wall and can be risk factors for epigastric hernias.

Symptoms of an Epigastric Hernia

Most epigastric hernias cause no symptoms. They are often not noticed until an imaging test is performed for another purpose.

In some cases, a bulge near the belly button can become noticeable. In infants with epigastric hernias, they may be more apparent when the baby is crying or having a bowel movement.

While epigastric hernias can cause pain, they often are not felt at all.

Because epigastric hernias are often asymptomatic, it is not uncommon for an adult to be diagnosed with one that was developed before birth.

Diagnosing an Epigastric Hernia

These small hernias are often diagnosed during a CT scan or another imaging test performed for a different reason. They may never cause any symptoms.

If an epigastric hernia is causing symptoms, it may be diagnosed through a physical exam or through imaging tests such as ultrasounds.

Epigastric Hernia treatment

If a hernia is small and is not causing any notable symptoms, it may be left unrepaired. Your doctor may wish to monitor it to see if it gets larger or causes any issues.

If an epigastric hernia frequently protrudes, it may be repaired for cosmetic reasons.

When tissue gets stuck in a hernia, this is known as an incarceration. Often, this tissue can be pushed back inside when the patient is lying on their back.

In infants who have epigastric hernias, repairs are often put off for several months. This is because babies are better able to tolerate anesthetic once they are older, which reduces any risks associated with surgery. As long as the hernia is not getting larger, the chances of complications are small.

An incarcerated hernia can become dangerous if strangulation occurs. This happens when the blood supply is cut off from the tissue or organ parts that are trapped inside the incarceration. Because cell death becomes likely, a strangulated hernia is considered an emergency.

If you have an epigastric hernia, talk to your doctor about your treatment options. Your doctor can tell you whether this hernia should be left alone or whether surgical repair is needed.