🩺 Chapter 420: Epigastric Hernia

Nelson Textbook of Pediatrics 22nd Edition — Epigastric hernia is a ventral hernia in the midline of the abdominal wall between the xiphoid process and the umbilicus (linea alba). It typically contains preperitoneal fat (rarely bowel). Usually presents as an asymptomatic palpable mass, but may cause pain. Treatment: elective surgical repair (incarceration/strangulation is very rare).

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📋 30 Clinical Scenarios — Epigastric Hernia

📇 High‑Yield Review Cards (Epigastric Hernia)

🩺 Clinical Presentations: Epigastric Hernia

Select a presentation for diagnostic clues and management.

📋 Stepwise Evaluation & Management of Epigastric Hernia

🔑 Key Principles — Epigastric Hernia (Nelson Ch.420)
• Definition: Midline hernia in the linea alba between xiphoid and umbilicus.
• Contents: Preperitoneal fat (most common). Rarely omentum or small bowel (if large defect).
• Clinical: Usually small (1-2 cm), firm, non-reducible mass, may be painful. Often multiple.
• Natural history: Does not resolve spontaneously. Incarceration/strangulation is rare due to small size.
• Treatment: Elective surgical repair (primary fascial closure) for symptomatic or enlarging hernias.

    ⚡ Reflex Prompts — Epigastric Hernia Decisions

    📖 Epigastric Hernia — Core Summary (Nelson Ch.420)