Epigastric hernia: When is surgery required?

Written by: Mr Filippo Di Franco
Published: | Updated: 18/07/2023
Edited by: Sophie Kennedy

In this informative guide to epigastric hernias, highly respected consultant general surgeon Mr Filippo Di Franco explains what can aggravate the condition, the symptoms patients typically experience and when surgical intervention is required.




What is an epigastric hernia?


An epigastric hernia protrudes through the abdominal wall. More specifically, epigastric hernias occur in the upper part of the abdominal wall between the umbilicus and the lower part of the breast bone, usually on the midline.



What are the symptoms of an epigastric hernia?


Usually, patients with an epigastric hernia complain of a swelling in the midline between the umbilicus and the lower part of the breast bone. This can cause pain which becomes more obvious when a patient is standing for a long period of time or coughing or doing any intense physical activity.



What aggravates an epigastric hernia?


An epigastric hernia can be aggravated by any situation which increases the intraabdominal pressure. This could occur when straining, coughing or when performing physical activity.



How serious is an epigastric hernia?


An epigastric hernia can cause pain but might be complicated by a condition which is called incarceration strangulation. This usually happens when some fatty tissue protrudes through the hernia defect and it isn’t possible to push it back within the abdomen. In these circumstances, the condition is called incarceration and if the blood supply to the tissue is compromised, the hernia becomes strangulated. This is a medical emergency which may require urgent surgical intervention.



Do epigastric hernias always need surgery?


Epigastric hernias do not necessarily require surgery. The treatment plan depends on whether the hernia is symptomatic or not. Usually, if an epigastric hernia is causing pain, it would be advisable to perform an operation because of the risk of complications such as incarceration strangulation.




If you are seeking treatment for an epigastric hernia or are concerned about your symptoms, you can schedule an appointment with Mr Di Franco by visiting his Top Doctors profile.

Mr Filippo Di Franco

By Mr Filippo Di Franco

Mr Filippo Di Franco is a leading consultant general surgeon who specialises in upper gastrointestinal surgery and laparoscopic surgery. With over 20 years of experience, Mr Di Franco is highly skilled in the treatment of gallstones and hernias, the management of abdominal pain, and frequently performs laparoscopy, endoscopy, and gastroscopy procedures.  

Mr Di Franco earned his first medical degree from the University of Catania, Italy in 1995. He then relocated to the UK and went on the complete both basic and higher surgical training in England. In 2010, he was awarded his Doctor of Medicine from Newcastle University.  

In 2011, Mr Di Franco became a consultant surgeon at Hinchingbrooke Hospital, part of the North West Anglia NHS Foundation Trust, where he continues to treat patients. Mr Di Franco pioneers laparoscopic (key-hole or minimally invasive techniques) to improve his patients’ experience, by reducing pain and recovery time. Between 2015 and 2017, he held the role of the associate medical director of the surgery division at Hinchingbrooke Health Care NHS Trust and was in charge of the clinical governance and performance of this division.  

In addition to his clinical work, Mr Di Franco is actively involved in research. His work has been included in revered publications such as the British Journal of Surgery and the Oxford Handbook of Clinical Surgery. He has presented his work at various national and international conferences. Additionally, Mr Di Franco is an educational supervisor and teaches medical students and trainee surgeons regularly.  

Mr Di Franco is a fellow of the Royal College of Surgeons and he offers his expertise as an Expert Witness for Medicolegal Work.  

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