PT  - JOURNAL ARTICLE
AU  - König, Tatjana T
AU  - Oerters, Laura S
AU  - Spiller, Ljuba
AU  - Schwind, Martin
AU  - Born, Mark
AU  - Oetzmann von Sochaczewski, Christina
AU  - Heydweiller, Andreas C
TI  - Epigastric hernias in children and the use of ultrasound in its diagnosis
AID  - 10.1136/wjps-2022-000544
DP  - 2023 Apr 01
TA  - World Journal of Pediatric Surgery
PG  - e000544
VI  - 6
IP  - 2
4099  - http://wjps.bmj.com/content/6/2/e000544.short
4100  - http://wjps.bmj.com/content/6/2/e000544.full
SO  - World Jnl Ped Surgery2023 Apr 01; 6
AB  - Introduction There is a paucity of clinical data on pediatric epigastric hernias despite them accounting for up to 6% of all hernia repairs in children. We aimed to provide additional data to supplement those 117 cases of a recent systematic review and to further clarify the role of ultrasound in diagnosing pediatric epigastric hernia.Methods We retrospectively included all 60 patients treated for epigastric hernias in children in two tertiary pediatric surgical departments within 12 years. Associations were tested via point-biserial correlation analyses.Results Epigastric hernias primarily affected preschool children with a median age of 39 months. The vast majority of patients (88%) presented with swelling that was occasionally (30%) accompanied by pain. Fascial defects could be found during clinical examination in 45% of patients with a median size of 5 mm (95% CI 3 to 10). Smaller defects were less likely to be palpable (r=−0.44, 95% CI −0.08 to −0.7, p=0.021). Likewise, ultrasound was used more frequently with smaller fascial defect sizes (r=−0.51, 95% CI −0.16 to −0.74, p=0.007). Laparoscopic repair was used in 11 patients (19%) and more often (4/11) in combination with another simultaneous procedure than open repair (11/48).Conclusions Epigastric hernias are primarily a condition of the preschool child. Ultrasound can be beneficial if the diagnosis cannot be made clinically; otherwise, it is abdicable if it does not change the management of the patient’s epigastric hernia. Laparoscopic repairs might be beneficial for children with multiple defects or simultaneous procedures.Data are available upon reasonable request. Deidentified data will be supplied upon request to the corresponding author.