Spigelian hernia
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A Spigelian hernia (or lateral ventral hernia) is a hernia through the spigelian fascia, which is the aponeurotic layer between the rectus abdominis muscle medially, and the semilunar line laterally. These hernias almost always develop at or below the linea arcuata, probably because of the lack of posterior rectus sheath. These are generally interparietal hernias, meaning that they do not lie below the subcutaneous fat but penetrate between the muscles of the abdominal wall; therefore, there is often no notable swelling.
Most of these hernias are small, and, as such, there is a high risk of strangulation. Most of them develop around age 50 (4th-7th decade of life). As an entity, they are rare,[1] when compared other types of hernias.
Symptoms and diagnosis
Patients typically present with either an intermittent mass, localized pain, or signs of bowel obstruction.[1] Ultrasonography or a CT scan can establish the diagnosis.
Treatment
These hernias should be repaired because of the high risk of strangulation;[1] fortunately, surgery is straight-forward, with only larger defects requiring a mesh prosthesis.
Eponym
Adriaan van den Spiegel, a surgeon-anatomist born in Brussels, described this hernia in 1645.
References
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
