Eur J Pediatr Surg 2022; 32(02): 139-145
DOI: 10.1055/s-0040-1719056
Review Article

Epigastric Hernias in Children: A Personal Series and Systematic Review of the Literature

Georges K. Tinawi
1   Department of Paediatric Surgery, Wellington Children's Hospital, Wellington, New Zealand
,
Mark D. Stringer
1   Department of Paediatric Surgery, Wellington Children's Hospital, Wellington, New Zealand
› Institutsangaben

Abstract

Epigastric hernias are relatively uncommon in children, and there is a paucity of literature on their incidence, presenting features, natural history, and surgical outcomes. A systematic review was conducted according to PRISMA guidelines. Articles describing the incidence, outcome, and interventions for pediatric epigastric hernias, both open and laparoscopic, were analyzed. Eight relevant articles published between 1975 and 2019 were included in the analysis. Of 81 children, 58% were females, 35% were symptomatic and 8% were multiple. All hernias contained preperitoneal fat only and were repaired using standard open surgery or laparoscopic techniques. No recurrences were recorded. In a personal series of 37 hernias in 36 children of median age 4 years, there were no recurrences; however, this series included two children with a recurrent or persistent epigastric hernia after surgery by others. Epigastric hernias in children are relatively uncommon. They typically contain only preperitoneal fat but more than a third are symptomatic. Standard open repair can be undertaken with minimal morbidity. Laparoscopic repair takes longer and provides a marginal cosmetic benefit.



Publikationsverlauf

Eingereicht: 11. Juni 2020

Angenommen: 21. September 2020

Artikel online veröffentlicht:
10. November 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6 (07) e1000097
  • 2 Coats RD, Helikson MA, Burd RS. Presentation and management of epigastric hernias in children. J Pediatr Surg 2000; 35 (12) 1754-1756
  • 3 Albanese CT, Rengal S, Bermudez D. A novel laparoscopic technique for the repair of pediatric umbilical and epigastric hernias. J Pediatr Surg 2006; 41 (04) 859-862
  • 4 Babsail AA, Abelson JS, Liska D, Muensterer OJ. Single-incision pediatric endosurgical epigastric hernia repair. Hernia 2014; 18 (03) 357-360
  • 5 Moreira-Pinto J, Correia-Pinto J. Scarless laparoscopic repair of epigastric hernia in children. Hernia 2015; 19 (04) 623-626
  • 6 Jun Z, Na J, Zhen C. et al. Single-incision laparoscopic approach for linea alba hernia in children. J Minim Access Surg 2019; 15 (01) 42-45
  • 7 Bugenstein RH, Phibbs Jr CM. Abdominal pain in children caused by linea alba hernias. Pediatrics 1975; 56 (06) 1073-1074
  • 8 Deie K, Uchida H, Kawashima H. et al. Operative procedures of single-incision laparoscopic repair of pediatric epigastric hernia have become simple and feasible with the use of a novel suture-assisting needle. J Pediatr Surg Case Rep 2016; 4: 22-26
  • 9 Tatekawa Y, Yamanaka H, Hasegawa T. Single-port laparoscopic repair of an epigastric hernia using an epidural needle. Int J Surg Case Rep 2013; 4 (03) 262-264
  • 10 Ameh EA. Giant congenital epigastric hernia. West Afr J Med 1999; 18 (02) 151-152
  • 11 Burcharth J, Pedersen MS, Pommergaard HC, Bisgaard T, Pedersen CB, Rosenberg J. The prevalence of umbilical and epigastric hernia repair: a nationwide epidemiologic study. Hernia 2015; 19 (05) 815-819
  • 12 Golby M. Acute abdominal wall hernias in infants and children. Am J Surg 1967; 114 (06) 888-893
  • 13 Lang B, Lau H, Lee F. Epigastric hernia and its etiology. Hernia 2002; 6 (03) 148-150
  • 14 Ponten JE, Somers KY, Nienhuijs SW. Pathogenesis of the epigastric hernia. Hernia 2012; 16 (06) 627-633
  • 15 Ponten JE, Leenders BJ, Charbon JA, Nienhuijs SW. A consecutive series of 235 epigastric hernias. Hernia 2015; 19 (05) 821-825
  • 16 Axer H, Keyserlingk DG, Prescher A. Collagen fibers in linea alba and rectus sheaths. I. General scheme and morphological aspects. J Surg Res 2001; 96 (01) 127-134
  • 17 Moschcowitz AV. Epigastric hernia without palpable swelling. Ann Surg 1917; 66 (03) 300-307
  • 18 Askar OM. Aponeurotic hernias. Recent observations upon paraumbilical and epigastric hernias. Surg Clin North Am 1984; 64 (02) 315-333
  • 19 Korenkov M, Beckers A, Koebke J, Lefering R, Tiling T, Troidl H. Biomechanical and morphological types of the linea alba and its possible role in the pathogenesis of midline incisional hernia. Eur J Surg 2001; 167 (12) 909-914
  • 20 Fachinelli A, Trindade MR, Fachinelli FA. Elastic fibers in the anterior abdominal wall. Hernia 2011; 15 (04) 409-415
  • 21 Pentney BH. Small ventral hernias in children. Practitioner 1960; 184: 779-781
  • 22 Muschaweck U. Umbilical and epigastric hernia repair. Surg Clin North Am 2003; 83 (05) 1207-1221
  • 23 Kokotovic D, Sjølander H, Gögenur I, Helgstrand F. Watchful waiting as a treatment strategy for patients with a ventral hernia appears to be safe. Hernia 2016; 20 (02) 281-287
  • 24 Henriksen NA, Montgomery A, Kaufmann R. European and Americas Hernia Societies (EHS and AHS). et al. Guidelines for treatment of umbilical and epigastric hernias from the European Hernia Society and Americas Hernia Society. Br J Surg 2020; 107 (03) 171-190