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Suggest treatment for epigastric hernia

Answered by
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 12447 Questions

Posted on Tue, 14 Mar 2017 in Abdominal Pain
Question: Hi,

My wife is diagnosed with epigastric hernia and she's one month pregnent now.

USG Upper Abdomen Report:
A small (15mm x 10mm) defect is seen between the two recti muscles in the epigastric region, through which bowel loops are seen to herniate into the anterior abdominal wall layers. The herniac sac measures apprx 48 x 32 x 22 mm and contents appear reducible.

My concern is how this condition can affect her pregnency and the baby.
What can be done and the steps that needs to be taken from now.
Are there any risks involved.
Answered by Dr. T Chandrakant 42 minutes later
Brief Answer:
As detailed below.

Detailed Answer:
Thanks for your query.
Noted the history about your wife and understood the concerns.
Salient points: one month pregnancy - USG > 15x10 mm opening - epigastric hernia - bowel loops herniate - sac is 48x32x22 mm - contents reducible - concerns about how is this going to affect her pregnancy and baby - what can be done - steps to be taken from now - risk ?

My concern is how this condition can affect her pregnancy and the baby.
> This condition will not affect baby.
This may not affect pregnancy too. On the contrary pregnancy can lead to obstruction as the pregnancy advances.

What can be done and the steps that needs to be taken from now.
> Since there is one month pregnancy, nothing to be done at the moment as you both would like to continue with pregnancy, I suppose.
To lead the life as usual and to see only one thing that the contents like intestines and fat does not get obstructed. The hernia needs to be in reduced position all the time. As the pregnancy advances the abdominal musculature too relaxed and may not cause any problem.
In so many years of my practice I have not seen any case getting obstructed hernia during pregnancy in spite many women get umbilical hernia secondary to pregnancy.

Are there any risks involved?
> Risk is only of obstruction of the hernia leading to further complications if not kept in reduced position.

Out or curiosity, a few questions from my side:
Were you not aware of the epigastric hernia before pregnancy occurred?
Does she have any symptoms?
Is this the first pregnancy?
Would you both like to continue with?
Any other information you would like to share.

I hope this answer helps you.
Please feel free to give feedback and ask for further relevant queries if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. T Chandrakant 24 minutes later
Hi Dr.

Thanks for sharing your inputs. The answers to your queries:
Were you not aware of the epigastic hernia before pregnancy occured?
Ans: she felt a lump above umbalical region last year while she was doing plank in the gym. But did not diagnosed by any investigation. After that time she felt the same two days ago with acidity. She got diagnozed yesterday as having epigastric hernia.

Is this the first pregnancy?
Ans: Yes (she's 31 years old)

Would you both like to continue with?
Ans: yes

Please let us know if you have any furthe suggestions.
Answered by Dr. T Chandrakant 52 minutes later
Brief Answer:
Noted the feedback.

Detailed Answer:
Thanks for your feedback.
Noted the additional points.
You may please continue the pregnancy and continue to have a careful watch and keep the hernia in reduced position.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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