Epigastric HerniaWhat is an epigastric hernia?An epigastric hernia is an opening or weakness in the fibrous tissue of the abdomen between the breast bone and the belly button. It is caused by incomplete closure of the fibrous tissue of the abdomen during development. What does an epigastric hernia look like?When your child cries, stools, or bears down a small bump will push out somewhere along the center of the abdomen. Usually the bump is filled with fluid or fat. As soon as the child relaxes, the bump will sink back into the abdomen. Does my baby need surgery for this type of hernia?This type of hernia will not close on its own and must be surgically repaired. Repair is elective and is usually recommended within a few months of discovery. Repair may be recommended sooner if the child is experiencing pain. If not repaired the hernia may enlarge or become painful. How is the hernia repaired?A general anesthetic is used. It is very important for you and the surgery nurse to mark the exact site of the bump with a special marker before your child goes to sleep the day of surgery. A small incision is made in the abdomen just over the hernia. The hernia sac and fiber tissue layers are sutured closed with dissolvable suture. The outer skin is then closed with skin glue and/or special tapes. How do we care for the incision?You may keep a bandage over the incision for about 5-7 days to protect it from rubbing on diapers or pants if this is more comfortable for your child. Keep the incision dry for 24 hours, then the child may shower or sponge bathe. Be sure to gently pat the incision dry after bathing, avoid rubbing. Do not soak the incision in water for one week. Once the child resumes normal bathing, the skin glue or tapes will begin to peel away. What restrictions will my child have after the surgery?Your child can return to normal activity or school the next day, but should avoid vigorous physical activity (gym class, tree climbing) for 2-4 weeks. Your child should also avoid lifting anything greater than 10 pounds for one month after surgery. Will my child have pain?Most children do not have severe pain after an epigastric hernia repair. Most often over-the-counter pain relievers (ie. Children's Tylenol or Children's Advil) are adequate for pain control. Occasionally we will provide you with a prescription for Tylenol with Codeine for more severe pain. Do NOT mix a dose of regular Tylenol for Children and a dose of Tylenol with Codeine - this may be too much Tylenol and could be harmful. Remember that codeine may make your child drowsy, nauseated, or constipated. Have your child take the codeine with food and encourage them to drink plenty of liquids. Teenagers should not drive or operate heavy machinery while taking codeine. When should I call to speak with a nurse?If your child has:
If you have questions or concerns contact us at:Call the pediatric surgery office Monday through Friday 8am-5pm at (734) 764-4151. After hours, weekends, or holidays for emergent issues only, call the hospital paging operator and ask for the pediatric surgeon on call at (734) 936-6267. This information is provided by the University of Michigan Department of Surgery, Section of Pediatric Surgery and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact your health care provider or our offices. |
