Supraumbilical Hernia

The two long muscles of the abdomen meet in the middle along a band of firm tissue that runs from the breastbone down to the bellybutton. A supraumbilical hernia (sometimes called an epigastric hernia) occurs where there is a small weakness in this band just above the bellybutton, allowing a little fatty tissue from inside the abdomen to push through.

It usually appears as a small, firm lump in the midline that may be more obvious when your child is standing or straining. Some children notice mild aching or tenderness over the lump, but many have no symptoms at all.

Unlike an umbilical hernia at the bellybutton itself, a supraumbilical hernia sits in a part of the abdominal wall that does not close naturally as your child grows. The lump therefore tends to persist and may slowly become larger or more tender over time.

Repair is recommended when the hernia is causing discomfort, is enlarging, or simply so that it does not become a problem later. There is rarely any urgency, and the operation is usually scheduled at a convenient time. Your child's surgeon will confirm the diagnosis by examination and will mark the exact position of the lump before surgery, as it can be harder to feel once your child is asleep.

The repair is performed under a general anaesthetic as day surgery. Local anaesthetic is also used so your child wakes comfortably.

A small horizontal incision is made over the lump. The protruding fatty tissue is either returned to the abdomen or removed, and the gap in the midline is closed with stitches. Mesh is not needed. The skin is closed with dissolving stitches beneath the surface and covered with a small waterproof dressing or skin glue. The operation is short and your child can go home once awake, comfortable and eating and drinking.

Most children need only paracetamol or ibuprofen for a day or two and are back to normal activities quickly. A small firm ridge under the scar is normal and softens over a few months.

Keep the wound dry for a day or two, then bathing is fine. Avoid rough play, gymnastics and contact sport for around two weeks. Contact the team if there is fever, redness spreading from the wound, discharge, or the lump reappears. A follow-up appointment will be arranged to check the wound.