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Presentation and management of epigastric hernias in children
R D Coats1, M A Helikson, R S Burd
1Department of Surgery, Children's Hospital at University of Missouri Hospitals and Clinics, Columbia, MO 65212, USA.
Insights
Epigastric hernias are common in pediatric patients, often appearing in infancy. Surgical repair is recommended due to frequent symptoms or enlargement, with no reported recurrence or complications.
Area of Science:
- Pediatric Surgery
- Abdominal Wall Defects
Background:
- Epigastric hernias are common but rarely reported in children.
- Limited data exists on the presentation and management of pediatric epigastric hernias.
Purpose of the Study:
- To review the experience with epigastric hernias in children.
- To develop management recommendations for pediatric epigastric hernias.
Main Methods:
- Retrospective review of medical records for pediatric patients (<18 years) with epigastric hernias over 14 years.
- Data collected included presentation, operative findings, and postoperative outcomes.
Main Results:
- Forty children (4% of pediatric hernia cases) were evaluated.
- Hernias were present at birth in 30% and symptomatic or enlarging in 55%.
- Thirty-eight children underwent successful repair with no recurrence or morbidity.
Conclusions:
- Epigastric hernias are prevalent in children, often presenting in infancy.
- Surgical repair is recommended upon presentation due to frequent symptomatic or enlarging defects.
Background/Purpose:
Although epigastric hernias are common, there are no reports that describe the presentation and treatment of these defects in children. The authors reviewed their experience with these hernias to develop recommendations for their management in this age group.
Methods:
Medical records were reviewed for all children younger than 18 years who presented for evaluation of an epigastric hernia at our institution over 14 years. Data on presentation, operative findings, and postoperative results were obtained.
Results:
Forty children were evaluated for an epigastric hernia, representing 4% of all pediatric patients seen for treatment of a hernia. An epigastric hernia was first observed at birth in 12 patients (30%). All children presented with a mass in the epigastrium. The hernia was observed to be either symptomatic (abdominal wall pain or tenderness) or enlarging in 22 patients (55%). Thirty-eight children underwent repair, and 2 were lost to follow-up. There was no recurrence or morbidity associated with surgical repair of these defects.
Conclusions:
Epigastric hernias are common in children and frequently present in infancy. Because most are either symptomatic or enlarging, the authors recommend repair of these defects at the time of presentation.
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