Epigastric Hernia in Children: Symptoms & Treatment

Instructor: Justine Fritzel

Justine has been a Registered Nurse for 10 years and has a Bachelor's of Science in Nursing degree.

Hernias can occur for many different reasons and in many different locations. In this lesson, we will focus on epigastric hernias in children, their symptoms, and treatment for them.

What is that Lump on my Baby?

Jan and Mike are brand-new parents of a beautiful two-month-old baby boy named Heath. They are learning that parenthood doesn't come with a manual and are figuring it out day by day.

One day Mike was bathing Heath. Heath was crankier than usual and crying through his bath. Mike noticed a lump in the middle of Heath's belly, a couple inches above his belly button. Mike panicked, sure that it was something serious. He and Jan quickly made an appointment with the pediatrician.

Understanding Epigastric Hernias

The day of the appointment, Heath wasn't as fussy and the lump was hardly visible. Mike explained yesterday's events and what he had seen. The pediatrician, Dr. Mariam, undressed baby Heath to examine him. Of course, with all this activity, Heath became fussy again and the lump was more prominent.

Dr. Mariam told the new parents that Heath had a hernia. A hernia is a protrusion of an internal organ through the muscle wall that contains it. In Heath's case, this was an epigastric hernia, which is located between the breastbone and belly button (sternum and umbilicus).

Mike seemed shocked and said he thought hernias were only from heavy lifting or straining. The pediatrician explained that epigastric hernias could be a congenital condition, meaning that babies were born this way. During development, Heath's abdominal wall didn't close completely.

This opening results in fat being pushed through the abdominal wall, causing the lump that they were seeing. When Heath strains, like when he is crying or if he is having a bowel movement, the lump is more predominant. Heath's epigastric hernia is small, but if it increased in size, part of the intestine could push through the opening.

Symptoms of Epigastric Hernias

Dr. Mariam explained that generally there are no symptoms associated with the epigastric hernia, but Heath may experience mild discomfort when the fat that is pushed through the muscle gets pinched.

There can be further complications associated with an epigastric hernia. If the hernia were to enlarge, part of the intestines might protrude through. An incarcerated or strangulated hernia could result if the blood supply to the herniated portion was cut off. In this case, the color of the skin would be dark and Heath would have increased pain. If this were to happen, they would want to take Heath into the emergency room.

Treatment Options

Dr. Mariam tells Jan and Mike that Heath doesn't seem to be having any pain with his epigastric hernia. It's very small and since he is so young, she wants to monitor the hernia for a while before deciding to do any further treatment.

Since Heath's abdominal muscles didn't fully close upon development, there is a chance that as time goes by, the muscles will continue to grow and close the opening. If this doesn't happen, as long as Heath isn't have any complications, she would like to wait a year or two before considering surgery.

At that time, surgery would involve pushing the fat back into the abdomen and closing the hole in the muscle. Heath would go home the same day as the surgery and full recovery is usually within a couple weeks.

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