{"id":24814,"date":"2025-07-23T11:03:07","date_gmt":"2025-07-23T10:03:07","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=24814"},"modified":"2026-06-23T12:11:15","modified_gmt":"2026-06-23T11:11:15","slug":"epigastric-hernia","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatrics\/paediatricsurgery\/epigastric-hernia\/","title":{"rendered":"Epigastric hernia"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Epigastric hernias occur in the midline between the xiphisternum and the umbilicus. These hernias are due to a small defect in the linea alba.&nbsp; A swelling may be visible and palpable which represents a small protrusion of pre-peritoneal fat through the fascial defect.&nbsp; The underlying fascial defect will be much smaller than the visible swelling.&nbsp; These hernias do not self resolve but can look less prominent as the child\u2019s body shape changes.&nbsp; Some children may have more than one fascial defect.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These are common in childhood. Epigastric hernias are usually of cosmetic relevance only.&nbsp; It would be rare for such a hernia to cause abdominal pain or other symptoms.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ultrasound scan is NOT required.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Special Considerations<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Very rarely, the pre-peritoneal fat which has protruded through the fascial defect will become tender which may be due to venous congestion and potential ischaemia of the fatty tissue.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>PC, LS, JB JUNE 26<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\"><strong>Who to refer:<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Children in whom there is uncertainty as to nature of an upper midline swelling or in whom the family wish to discuss surgery on cosmetic grounds.<\/li>\n\n\n\n<li>Children in whom an epigastric hernia is tender.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>How to refer<\/strong>:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Referral is via SCI Gateway<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Referral Priority<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>An asymptomatic supra-umbilical and epigastric hernia will be vetted as a routine referral.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Surgical Priority<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Repair of supra-umbilical and epigastric hernia is a non-urgent procedure.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\"><strong>Options for Management in Primary care<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Simple reassurance.<\/li>\n\n\n\n<li>Ultrasound scan is NOT required.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Epigastric hernias occur in the midline between the xiphisternum and the umbilicus. These hernias are due to a small defect in the linea alba.&nbsp; A swelling may be visible and palpable which represents a small protrusion of pre-peritoneal fat through the fascial defect.&nbsp; The underlying fascial defect will be much smaller than the visible swelling.&nbsp;<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":4270,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[1287],"class_list":["post-24814","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-epigastric-hernia"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/paediatric\/paediatricsurgery\/https-apps-nhslothian-scot-refhelp-epigastric-hernia\/\" rel=\"tag\">Epigastric hernia<\/a>","rttpg_excerpt":"Epigastric hernias occur in the midline between the xiphisternum and the umbilicus. These hernias are due to a small defect in the linea alba.&nbsp; A swelling may be visible and palpable which represents a small protrusion of pre-peritoneal fat through the fascial defect.&nbsp; The underlying fascial defect will be much smaller than the visible swelling.&nbsp;","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/24814","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=24814"}],"version-history":[{"count":6,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/24814\/revisions"}],"predecessor-version":[{"id":28469,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/24814\/revisions\/28469"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4270"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=24814"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=24814"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}