Umbilical and Epigastric Hernias

Navel and upper midline hernias can enlarge or become painful. Repair is planned around symptoms, defect size, abdominal-wall strength, body weight and future pregnancy.

When to Seek Urgent Care

Seek emergency care if the lump becomes suddenly painful, tense or impossible to push back, especially with vomiting, abdominal swelling, redness, fever or inability to pass stool or gas.

Understanding the Condition

An umbilical hernia forms at or near the navel. An epigastric hernia forms in the midline between the navel and breastbone. Fat often protrudes through a small gap; larger hernias may contain bowel.

A widening between the abdominal muscles, called rectus diastasis, can occur alongside a hernia. It is not itself a true hernia, but it can affect repair planning and recurrence risk.

How It Is Assessed

Examination usually confirms the diagnosis and measures the defect. Ultrasound can clarify a small or uncertain lump. CT is useful for larger, recurrent or multiple defects. The surgeon also reviews skin condition, body mass index, diabetes, smoking, previous surgery and pregnancy plans.

Illustration showing an epigastric hernia in the upper midline abdomen
An epigastric hernia appears in the midline above the navel.

When Is Surgery Considered?

Repair is commonly advised when the hernia is painful, enlarging, difficult to reduce or limiting activity. A small, reducible hernia with very little impact may be observed with clear emergency advice, but it will not close by itself in an adult.

Smoking cessation, diabetes control and an achievable weight plan can lower wound risk before elective surgery. Timing around a future pregnancy should also be discussed because pregnancy can stretch a repair.

Surgery and Important Risks

Repair returns the contents to the abdomen and closes the gap. Sutures alone may suit a very small defect in a carefully selected patient. Mesh reinforcement generally lowers recurrence for defects around 1 cm or larger. Open, laparoscopic or robotic surgery is chosen according to the size, number and position of the defects and any previous operations.

Risks include fluid collection, bleeding, infection, skin or navel problems, bowel injury, persistent discomfort and recurrence. The surgeon should explain where any mesh will sit and why that position suits your abdominal wall.

Recovery and Follow-up

Day-care or a short stay is common for smaller repairs. Early walking and deep breathing are encouraged. Support the wound when coughing and avoid constipation. Return to work and lifting depends on pain, wound healing and physical demands.

Contact the team for fever, spreading redness, wound discharge, vomiting, worsening pain or a swelling that becomes hard. A soft postoperative fluid collection may settle, but it should not be punctured at home.

Discuss Your Midline Hernia Repair

Review the defect size, abdominal-wall strength and personal risk factors to plan an appropriate repair.

Please bring: any ultrasound or CT images and report; details of previous abdominal operations; your work demands and any future pregnancy plans.