Spigelian hernia


A lateral ventral hernia through the Spigelian fascia, which is the aponeurotic layer between the rectus abdominis muscle medially, and the semilunar line laterally.

Compared to other types of hernias they are rare.

Such a hernia.does not lie below the subcutaneous fat but penetrates between the muscles of the abdominal wall; therefore, there is often no notable swelling.

Because Spigelian hernias are usually small and the risk of strangulation is high.

Most Spigelian hernias occur on the right side.

They occur in 4th–7th decades of life.

Patients usually present with either an intermittent abdominal mass, localized pain, or signs of bowel obstruction.

Diagnosis can be established by ultrasonography or a CT scan.

Abdominal CT scans provides the greatest sensitivity and specificity.

Due to the high risk of strangulation these types of hernias should be surgically repaired.

Laparoscopic repair results in less morbidity and shorter hospitalization compared with open procedures.

Larger defects require a mesh prosthesis.

Mesh-free laparoscopic suture repair is feasible and safe.

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