Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual
The Abdomen
Laparotomy and Abdominal Trauma
Abdominal trauma
Acute Abdominal Conditions
Assessment and diagnosis
Intestinal obstruction
Stomac and duodenum
Abdominal Wall Hernia
Groin hernia
Surgical repair of inguinal hernia
Surgical repair of femoral hernia
Surgical treatment of strangulated groin hernia
Surgical repair of umbilical and para-umbilical hernia
Surgical repair of epigastric hernia
Incisional hernia
Urinary Tract and Perineum
The urinary bladder
The male urethra
The perineum
Surgical Repair of Epigastric Hernia

Epigastric hernias are usually protrusions of properitoneal fat, but occasionally contain omentum. They appear through a defect in the linea alba and are normally found in the midline between the xiphisternum and the umbilicus. There is no peritoneal sac.


1 If the hernia is single, make a transverse incision over the swelling. Make a midline incision over multiple midline epigastric hernias.
2 Dissect the herniated fatty mass down to its neck, make an opening in the neck, and excise both the covering and the extra peritoneal fat. Define the fibrous margins of the defect and close it with interrupted non-absorbable suture as described for para-umbilical hernia.


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