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Pictures, Symptoms, Treatment & Causes of Epigastric Hernia

Epigastric Hernia Pictures


What is Epigastric Hernia?

This medical condition is a protrusion of tissue or structure out its normal position and occurs above your naval and below your ribcage along the midline of your abdomen. This bulge comes through your abdominal wall and normally gets no bigger than a golf ball. It normally bulges through your "linea alba", which is a visible strip of connective tissue. It is defined as the depressed line that goes between the six pack muscles and extends down the middle of your abdomen. What usually bulges through is fatty tissue. It is rare that your intestines bulge through. It is common to see these on infants at birth but can happen to anyone of any age, race, or gender. It is possible for a person to have more than one at a time.

Types of Epigastric Hernia

There are two different types of epigastric hernias.

  • Reducible epigastric hernia - this is the type in which the bulging tissue is pushing out of the hole or weakness and then falls back in again.
  • Incarcerated epigastric hernia - this is the type in which the bulging tissue becomes lodged in the protruded position. This is the type that is the most serious but is not usually considered an emergency.


In the beginning stages the symptoms are usually mild but serious complications, even death, can occur if any of the neighboring organs become incarcerated or the organs of your abdomen becomes lodged into your peritoneum, which is the serous membrane that forms the lining of your abdominal cavity. Some of the symptoms of having an epigastric hernia may include:

  • The first sign is swelling or a bulge in your abdomen. You can usually feel this when you have a bowel movement or if your bend over to get something. The exertion can also come from laughing, coughing, or crying. The exertion of any of these can cause a strain on your abdomen and give you a fullness feeling.
  • The skin surrounding your epigastric hernia may be blackish-blue in color. This symptom can indicate something serious because the discoloration of your skin happens when it has become strangled. This can happen when the blood flow is totally cut off from the hernia. If you notice this you need to seek immediate medical attention as it can cause death if you do not have it treated immediately. Sometimes with a strangulated epigastric hernia you could also experience diarrhea, abdominal swelling, vomiting, and severe pain.
  • Having unbearable or severe pain, which is usually in the upper belly. This usually happens when the epigastric hernia gets larger and gets trapped in the abdomen’s muscular wall. You may also notice a tender feeling around the area that is affected.
  • You may also run a fever which can range from low to high grade. If you have a fever this is a symptom of complications because if it is a simple epigastric hernia a person does not usually run a fever. If the fever is accompanied by nausea that induces vomiting you need to seek immediate medical attention. This is to help prevent the epigastric hernia from becoming a serious case.
  • At times your epigastric hernia may not be visible while at other times it is.
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Epigastric hernias are usually caused by a weakness or congenital defect in your abdominal walls or the connective tissue. This makes your abdominal walls weak. It can also be caused with a small portion of any of your abdominal organs such as your liver, stomach, etc or small portion of your intestine becomes caught up in the wall so your abdominal cavity. When any of these protrude into your peritoneum they can form a mass between your belly button and chest.

Other causes may include:

  • Straining when you are having a bowel movement
  • Lifting objects that are overtly heavy
  • Having an accumulation of fluid in your abdominal cavity
  • Persistent coughing
  • Obesity
  • Pregnancy


Your physician can easily diagnose an epigastric hernia during a physical examination because they are usually visible as a small bulge. The physician may also have you stand and cough in order to see the bulge more clearly as it comes out more from you coughing. If the physician is still not sure or if they want to determine how severe your epigastric hernia is they may have a CT scan, MRI, or ultrasound done so they can look internally at your abdominal wall between your belly button and breastbone.


It is essential that you have the epigastric hernia repaired before you develop complications that are life-threatening. To help you with the inflammation and pain of the epigastric hernia the physician may give you anti-inflammatory medication along with pain medication. If surgery is recommended it will be done using local anesthesia and they will remove the hernia sac completely. The parts that are not affected will be reconnected with sutures and then the wound is sealed. The surgeon will also strengthen the weakness in your abdominal walls by stitching a patch of nylon mesh in place or using permanent stitches. You will need to make sure that until the incision heals and your hernia is no longer there you exercise the right post-operative care. When you have surgery it may be as outpatient surgery or your may have to spend one or two nights in the hospital if there were any complications. There is a high success rate when you have this surgery.

If a child has an epigastric hernia the treatment will usually be put off until they are old enough to tolerate it unless it becomes a medical emergency. An epigastric hernia will not heal on its own so you will have to have surgery eventually. Some people opt to wait on surgery to repair their epigastric hernia until it begins to cause them problems but if they do wait they need to make sure that the do not wait so long that it becomes a medical emergency.


Gail Conneely on May 10, 2017:

I had this surgery in 2014. My Surgeon had to remove my stomach lining as he said it looked like swiss cheese. He used my oblique muscles to hold in the mesh and make for a stomach lining. Then I had my gall bladder removed about 8 months later. Then a umbilical hernia repaired. Then I was seeing a Gastroenterologist for stomach pain, did a CT to find that I have another epigastric hernia, but was told it was small and leave it be. That was several years ago. Now I have severe abdominal pain and huge swelling everyday.

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