Epigastric Hernia
This hernia may present at any age but is more common before the age of 40. It is present in 5% of patients.
It occurs in the midline between the umbilicus (belly-button) and the chest. The figure below shows the anatomy as seen in cross-section. The rectus abdominis muscles are the ones commonly referred to as 'six packs'. The peritoneum lines the inside of the abdomen and is separated form the back of the abdominal muscles by fat (extraperitoneal fat). It is this fat, sometimes with a small sac of peritoneum, that pokes through the tough tissue (linea alba) that holds the muscles together. The defect is usually very small. The hernia can therefore cause pain, does not tend to come and go but stays, and can strangulate.
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