Fracture in the upper abdomen and umbilical hernia

A rupture of the upper abdomen (epigastric hernia) is a bulging of the peritoneum through an opening in the middle of the upper abdomen. This rupture often occurs spontaneously with no apparent cause. In an umbilical hernia, the peritoneum bulges through the umbilical opening. This is a common fracture that often causes few symptoms.

Cause

Both fractures occur spontaneously. Umbilical hernia probably occurs because the umbilical ring does not close properly after birth. Risk factors for fractures in the upper abdomen include connective tissue diseases, smoking, fluid in the abdomen and a widening of the abdominal muscles.

Symptoms

You usually notice a painless swelling at the belly button or upper abdomen, which can sometimes be pushed back. The swelling increases with pushing or coughing. Sometimes pain develops, especially if fat tissue is wedged into the fracture. If there is severe, persistent pain and additional symptoms such as nausea, there may be a clamp fracture. In this case, immediate medical attention is necessary.

Diagnosis

Diagnosis is usually made by physical examination. An utrasound or a CT scan are only necessary in cases of doubt, large fractures or risk factors.

Treatment

The fracture is surgically repaired by replacing the peritoneum and reinforcing the abdominal wall with a plastic mesh. Smaller, symptomless fractures do not always require treatment. Surgery can be done via keyhole surgery, robotic surgery or open technique, usually under general anaesthesia and often as a day admission.

Complications may occur after surgery to repair an upper abdominal fracture or umbilical hernia:

  • Wound infection: must be cared for locally.
  • Wound fluid (seroma): usually recovers spontaneously.

Complications are rare. Contact your surgeon in case of persistent fever, chills, growing swelling or pain in the abdomen, persistent nausea or vomiting, difficulty breathing, or if fluid comes out of the wound.

How is the admission procedure?

On the day of surgery, you will come to the hospital in the morning, after which you will be operated on under anaesthesia. After surgery, you will be closely monitored and given pain medication. If urination is difficult after surgery, a temporary bladder tube may be needed. You may not do any heavy lifting for the first four weeks. Showering is allowed, but bathing only after two weeks. After one week you will see your general practitioner for a check-up.

A checkup with the surgeon is usually scheduled four to six weeks after surgery.

Departments

Would you like more information or to make an appointment? If so, please contact the department(s) below.

General and abdominal surgery

Want to know more about abdominal wall surgery?

For more information, take a look at the website of the abdominal wall center Limburg.

Abdominal wall center Limburg