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SCRIPT FOR EPIGASTRIC & UMBILICAL HERNIAS:
Script for Epigastric & Umbilical Hernias/ Ventral Hernia:
Intro:
Hello, welcome to our surgical educator podcast. I am your host or master of ceremony for this episode. Today, we will be discussing 2 0f the causes for ventral hernia- epigastric & umbilical hernias. We have Prof.Dr.Selvaraj with us to answer all our questions. Welcome doctor.
Dr.Selvaraj: Hello, MC, Good Morning.
Host: Good morning doctor. What is ventral hernia doctor?
Dr.Selvaraj: All hernias of the anterior abdominal wall except groin hernias are called ventral hernias. Epigastric, umbilical, incisional, spigelian and lumbar hernias are examples of ventral hernias.
Host: What is an epigastric hernia?
An epigastric hernia is a type of abdominal wall hernia that occurs in the epigastric region of the abdomen, which is the area between the belly button and the bottom of the breastbone or umbilicus and xiphisternum. This type of hernia is relatively common and can occur both in men and women.
Host: What causes an epigastric hernia?
A: An epigastric hernia occurs when a small section of abdominal tissue pushes through a weakened area in the abdominal wall- usually protrusion or herniation of extraperitoneal fat through a defect in the linea alba anywhere between the xiphoid process and the umbilicus, usually midway between these structures. This can be due to a variety of factors, including age, genetics, and lifestyle factors such as smoking or obesity. It is always an acquired problem and common in manual labourers.
Host: What are the different stages of this epigastric hernia?
Dr.Selvaraj: There are 3 different stages of it’s development
1. Symptomless—At the initial stage it is symptomless and often discovered by the patient himself as a swelling during washing his body- the extraperitoneal fat is protruding through the defect in linea alba- known as fatty hernia of linea alba.
2. Painful swelling—Localized pain exactly at the site of hernia as the fatty content of the hernia is pressed by the tight margins of the gap in the linea alba to produce partial strangulation.
3. Symptoms of peptic ulcer—As stated above. Pain may also be due to associated peptic ulcer or gall stones
Host: What are the symptoms of an epigastric hernia?
Dr. Selvaraj: The most common symptom of an epigastric hernia is a small bulge or lump in the upper abdominal area, which may be painful or tender to the touch. Some patients may also experience discomfort or a burning sensation in the affected area, especially when lifting heavy objects or engaging in strenuous physical activity.
Host: How is an epigastric hernia diagnosed?
Dr.Selvaraj: An epigastric hernia is typically diagnosed through a physical exam by a healthcare provider, who will look for signs of a bulge or lump in the upper abdomen. Imaging tests such as an ultrasound or CT scan may also be used to confirm the diagnosis in a doubtful case.
Host: Can an epigastric hernia go away on its own?
Dr.Selvaraj: No, an epigastric hernia will not go away on its own and may require surgical treatment to prevent complications such as strangulation, which occurs when the tissue within the hernia becomes trapped and loses its blood supply.
Host: What is the treatment for an epigastric hernia?
Dr.Selvaraj: The most common treatment for an epigastric hernia is surgical repair, which involves the closure of the weakened area of the abdominal wall using a surgical mesh. In some cases, minimally invasive laparoscopic surgery may be used to repair the hernia.
Host: What is the recovery time for epigastric hernia surgery?
Dr.Selvaraj: Recovery time after epigastric hernia surgery can vary depending on the individual patient and the type of surgery performed. Most patients can expect to resume normal activities within 2-4 weeks after surgery, although heavy lifting and strenuous exercise should be avoided for several weeks.
Host: Are there any complications associated with epigastric hernia surgery?
Dr.Selvaraj: As with any surgical procedure, there are risks associated with epigastric hernia surgery, including infection, bleeding, and damage to surrounding tissues. However, serious complications are rare, and most patients experience a smooth recovery with few complications.
Host: Thank you for answering questions on epigastric hernia. Now let us discuss about umbilical hernia. What causes an umbilical hernia?
Dr.Selvaraj: An umbilical hernia occurs when a small section of abdominal tissue pushes through a weakened area in the abdominal wall around the belly button. This can occur both in children as congenital lesion or in adults as acquired lesion. In children it is because of either absence of umbilical fascia(Richet’s fascia) or incomplete closure of umbilical defect. In children common cause is umbilical sepsis. In adults’ hernia does not protrude through the umbilical cicatrix. It is a protrusion through the linea alba just above the umbilicus (supraumbilical) or occasionally below the umbilicus (infraumbilical). That’s why it is called paraumbilical hernia.
Host: What are the symptoms of an umbilical hernia?
Dr.Selvaraj: The most common symptom of an umbilical hernia is a small bulge or lump in the area around the belly button/umbilicus. The bulge may become more pronounced when coughing, straining, or standing upright. Some patients may also experience discomfort or pain in the affected area.
Host: How is an umbilical hernia diagnosed?
Dr.Selvaraj: An umbilical hernia is typically diagnosed through a physical exam by a healthcare provider, who will look for signs of a bulge or lump in the area around the belly button/umbilicus. Imaging tests such as an ultrasound or CT scan may also be used to confirm the diagnosis in doubtful cases.
Host: How to differentiate between umbilical hernia from paraumbilical hernia?
Host: Can an umbilical hernia go away on its own?
Dr.Selvaraj: In infants, umbilical hernias may resolve on their own within the first few years of life as the abdominal muscles strengthen. However, in adults, umbilical hernias will not go away on their own and may require surgical treatment to prevent complications such as strangulation, which occurs when the tissue within the hernia becomes trapped and loses its blood supply.
Host: What is the treatment for an umbilical hernia?
Dr.Selvaraj: For pediatric umbilical hernia upto 3 years conservative treatment and after that if it persists then only surgery. For adult paraumbilical hernia surgical repair must be done. In the past we were doing Mayo’s repair using double breasting closure technique but nowadays doing either open overlay mesh repair or laparoscopic IPOM- Intra Peritoneal Onlay Mesh repair,
Host: What is the recovery time for umbilical hernia surgery?
Dr.Selvaraj: Recovery time after umbilical hernia surgery can vary depending on the individual patient and the type of surgery performed. Most patients can expect to resume normal activities within 2-4 weeks after surgery, although heavy lifting and strenuous exercise should be avoided for several weeks.
Host: Are there any complications associated with umbilical hernia surgery?
Dr.Selvaraj: As with any surgical procedure, there are risks associated with umbilical hernia surgery, including infection, bleeding, and damage to surrounding tissues. However, serious complications are rare, and most patients experience a smooth recovery with few complications.
Host: Thank you Dr Selvaraj for answering all our questions.
Dr.Selvaraj: Thank you MC and see you in the next episode.
Host:
That concludes our podcast on Epigastric & umbilical hernias. We hope that this information has clarified this common type of hernia. If you have any further questions or concerns, be sure to talk with your healthcare provider.
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Thank you for listening and join us again for our next podcast where we will be discussing the other 2 causes for ventral hernia- Incisional & spigelian hernias.
Bye bye until we are going to meet you again in the next episode.
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