Epigastric hernias occur somewhere between the belly button and the breast bone. They arise in the linea alba which is a condensation of all of the layers of the abdominal wall that occurs precisely in the midline of the abdominal wall. This is a layer of dense and strong fascia that is penetrated by blood vessels and nerves. The areas of penetration is where these hernias start.
Epigastric hernias tend to be small but very painful hernias. In slender patients we have seen hernias as small as a pea that were symptomatic enough for an adult to seek medical attention.
The repair is a sutured repair which frequently requires only one stitch.
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"Milan—Chronic groin pain after hernia surgery is now considered the most important issue facing inguinal hernia surgeons and their patients. Yet, there is still much uncertainty surrounding what causes the pain and how to prevent it." - Victoria Stern, General Surgery News