Hernia of the white line of the abdomen in adults

Epigastric hernia or, more familiar in our country, the diagnosis is a hernial formation of the white line of the abdomen, a painful condition when fat or body tissues protrude through the abdominal wall in the gap between the sternum and the navel, located exactly on the white line. Often there are no symptoms with this type of hernia, and they go unnoticed for a long time. This type of hernia is usually small, and there may be several hernias in this area at the same time. Often hernias are combined with umbilical. Despite minor symptoms, they can sometimes provoke soreness mainly in the upper abdomen.

Along with the umbilical hernia, the formation located along the white line of the abdomen is classified as a class of hernial lesions of the abdominal wall.

What is a hernia

By its definition, a hernia of the abdominal wall is an abnormal protrusion of the contents of the abdomen through a defect in its wall. In other words, part of your insides sticks out through a hole in the abdominal tissues, and is covered only by skin. Primary ventral hernias most often occur in the midline of the abdomen – a thin strip along the center of the abdomen where there are no muscles, only a strip of connective tissue. Defects in this strip are called umbilical or epigastric hernias, depending on their location. An umbilical hernia is a hernia of the navel (umbilical ring – to be extremely precise). An epigastric hernia is any other hernia in the midline of the abdomen (above the navel). There is a group of much rarer lateral hernias called spiegel and lumbar hernias. They form on the left or right side of the abdomen.

Epigastric hernias are quite common, and it is estimated that 25% of the population has already been treated or has these hernias. Most have a hole (defect) in the abdominal wall of a small size (1 – 2 cm), and the hernia contains only adipose tissue (without intestinal loops). However, the hernial sac, if the size of the defect is large, may also contain the intestines and other abdominal organs.

Symptoms of a hernia of the white line of the abdomen in adults

This hernial pathology often causes the appearance of a bump, a bulge with smooth edges in the area slightly below the sternum, but above the patient’s navel. The bulge can be present all the time, regardless of the position of the body (lying, standing or sitting) or occurs only when a person coughs, sneezes or laughs too much. If in some cases patients report a slight bulge, the area of ​​the hernia can grow in the absence of any medical attention to the size of a quail or even a chicken egg (or even more). Some people also develop more than one epigastric hernia (several in a row, in a chain, or two or three far apart). Although it is not common for an epigastric hernia to show any symptoms, patients may notice swelling, swelling, redness, or pain along the linea alba or within the hernia itself.

Untreated, large and neglected epigastric hernia can cause severe pain and complications due to infringement or provocation of intestinal obstruction. Urgent symptoms of an epigastric hernia include:

• heat;
• lack of appetite;
• increased pain or swelling;
• nausea;
• vomiting;
• development of bleeding, peritonitis or other problems.

Causes of a hernia of the white line of the abdomen in adults

This type of hernia is classified as a birth defect. That is, it is usually present from birth due to incomplete development of the abdominal wall, but it can appear at any age from newborn to old age.

This type of hernia occurs when the tissues in the center of the abdominal wall do not close (fuse into a tight band) completely during fetal development. In other words, most babies are born with an epigastric hernia, but in most children, due to the strengthening of muscles and tissues, it does not appear, the white line overgrows. But the true causes of an epigastric hernia have yet to be determined by doctors because people often don’t report it because they don’t have any major symptoms, such as pain, discomfort, or difficulty walking.

However, surgeons believe that a hernia of the white line occurs due to excessive stress created in the abdominal wall and predominantly in the epigastric region, closely adjacent to the diaphragm.

Treatment of a hernia of the white line of the abdomen in adults

These hernias do not go away on their own and require surgery to repair. However, if the hernia does not lead to an emergency, surgery may be delayed until the patient feels ready or when the child is older (in the case of children). Often, when a hernia of the white line of the abdomen is diagnosed in adults, it becomes problematic, complicated due to obesity, muscle weakness, or frequent stress on the abdominal wall due to heavy lifting or tension.

Diagnostics

Most people with an epigastric hernia have little to no symptoms caused by the defect. However, a swelling or lump above the belly button is one of the typical signs that a doctor may see. It’s easier to feel or actually see the hernia when the person is standing, the doctor can feel it, and the hernia may shrink or disappear again when the person lies down. Most of these hernias can be diagnosed by a surgeon with a simple physical examination.

Sometimes, when there is diagnostic uncertainty, an ultrasound scan or CT scan may be required. This is more likely in people who are overweight. Large hernias may require a CT scan to help plan surgery.

Modern treatments

The only way to really fix a hernia is surgery. It can be performed both openly (with incisions and suturing) and laparoscopically (through punctures with minimal tissue trauma). General anesthesia is used.

If the hole in the area of ​​the affected tissues at the linea alba is small, stitches are usually enough to close it and remove the hernia. However, for larger muscle defects, a special medical mesh may be required to restore the strength of the abdominal wall. Such a mesh is installed permanently and prevents the recurrence of a hernia.

Most patients can return to their normal activities within 2 to 4 weeks after surgery.

Prevention of a hernia of the white line of the abdomen in adults at home

Discomfort in the area of ​​the hernia may develop or worsen as the hernia becomes larger (grows). This can take anywhere from a few months to 10 years or more. During this time, a person does not need to restrict their activities in any way, unless a hernia of the white line causes too unpleasant symptoms when performing certain activities.

Surgery is the only way to treat a hernia, regardless of its type and the condition of the patient. Doctors are very positive about this operation and provide patients with a comfortable state of health throughout the procedure.

Specific preventive measures may be required, such as avoiding heavy lifting (greater than 2 kg) or strenuous exercise for at least 6 to 8 weeks after surgery. The doctor will explain when you can resume daily activities, what to avoid, and help get rid of any type of hernia with minimal chance of recurrence.

Popular questions and answers

We asked questions regarding the development of hernias and their treatment, symptoms to the therapist, gastroenterologist of the State Healthcare Institution of Public Health Clinic No. 30 in Volgograd, Vera Samsonova.