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Jun 26, 2023 · A spigelian hernia is a rare, abnormal protrusion of abdominal contents or peritoneum through a defect (spigelian fascia), which is comprised of the transversus abdominis and the internal oblique aponeuroses. It typically results from an underlying pathology that increases intra-abdominal pressure, abdominal wall trauma, or degeneration of ...
- 2023/06/26
A Spigelian is the type of ventral hernia where aponeurotic fascia pushes through a hole in the junction of the linea semilunaris and the arcuate line, creating a bulge. It appears in the lower quadrant of the abdomen between an area of dense fibrous tissue and abdominal wall muscles causing a (Spigelian aponeurosis ).
- Overview
- Symptoms
- Causes
- Diagnosis
- Treatment
- Outlook
- Conclusion
A spigelian hernia is a hernia through the spigelian fascia or layer of tissue that separates two groups of abdominal muscles, called the rectus muscles and lateral obliques. Symptoms can be similar to other abdominal hernias.
This type of hernia is also sometimes called a lateral ventral hernia. Unlike most hernias, spigelian hernias do not typically develop below layers of fat but rather between muscles and the fascia — tissue that connects them.
If left untreated, a spigelian hernia can block a portion of the bowel or cut off the blood supply to other organs and tissue. This condition can be life-threatening.
•Pain caused by a hernia may temporarily improve for an extended period.
•Once a hernia appears, surgical treatment is the only way to repair it.
•Spigelian hernias carry a high risk of complications, so it is important to seek prompt medical care.
The symptoms of a spigelian hernia can be similar to other hernias in the abdomen. This means that it is impossible to diagnose a spigelian hernia based on symptoms alone.
Because of their location between muscle layers, spigelian hernias tend not to cause noticeable swelling. Very thin people with visible abdominal muscles may notice some swelling, however.
Most people with a spigelian hernia experience abdominal pain or vague discomfort, especially when straining the abdominal muscles, such as when lifting or straining to have a bowel movement.
Some symptoms to watch for include:
•pain in the abdomen that seems unrelated to food, illness, or other common sources
•sudden changes in bowel function, such as constipation or a change in stool or bleeding
Spigelian hernias develop within a weakened area in the abdominal wall muscles.
The weakened area can be something a person is born with, or it can develop over time. If it develops over time, it can be because of an injury or increased pressure within the abdominal cavity. This weakened area allows tissue and organs to poke through the spigelian fascia.
Risk factors for a spigelian hernia include:
•a chronic cough, such as with the lung condition COPD
•frequently straining to have a bowel movement
•trauma to the abdomen, such as during surgery or due to a major injury
Diagnosing a spigelian hernia can be difficult, so it is important to report symptoms to your doctor. An ultrasound or CT scan of the abdomen can help with a diagnosis.
It may also be useful to consult a general surgeon, as these specialists have extensive knowledge of hernias, including spigelian hernias.
A spigelian hernia may also be discovered during surgery or procedures performed for other reasons, including:
•a bowel obstruction or blockage
•exploratory surgery
•surgery for another type of hernia
A spigelian hernia requires surgery for it to be repaired.
A minimally invasive surgery called laparoscopic hernia repair uses a small incision to guide a tube and a camera into the abdomen. With the assistance of the camera, doctors locate the hernia then use a mesh patch or stitches to repair the weakened abdominal wall.
A more invasive alternative involves a larger incision into the stomach. This surgery allows a doctor to directly view the hernia then make repairs to the damaged tissue.
A 2002 study compared laparoscopic and more conventional invasive surgery to repair spigelian hernias in two groups of 11 people. Laparoscopic surgery produced fewer complications. This suggests that it may be a preferred option for most people without complex hernias.
The recovery period for laparoscopic spigelian hernia surgery tends to be relatively short, lasting just 1 to 2 weeks. People who have more extensive surgery often have a longer recovery period.
People who experience complications, such as a bowel obstruction or an infection, may also require longer recovery times.
A person should report any new symptoms to a doctor. Fever, intense pain, or unexplained bleeding may mean that there are complications with recovery.
Most people can resume normal activities within 4 to 6 weeks and can begin light activities, such as walking and driving, 1 to 2 weeks following surgery. A person should strictly follow their surgeon’s recommendations and advice for the best possible outcomes during recovery.
People who have previously had a hernia are more likely to experience another hernia. However, a 2002 study followed up with 76 people who had undergone spigelian hernia surgery an average of 8 years later. It found just three had experienced another hernia.
The results suggest that most people who receive surgery for a spigelian hernia are unlikely to have another hernia in the following years. Their risk, however, remains higher than that of people with no history of hernias.
It can feel tempting to delay seeking treatment for sudden abdominal pain. This reaction may be especially true if the pain goes away for a while. However, spigelian hernias present serious medical risks.
They are relatively easy to treat, and most people will not need surgery again. So, when signs of a spigelian hernia appear, people should see a doctor.
Jun 20, 2017 · Symptoms of a Spigelian hernia vary from person to person and range from mild to severe. A common sign of this hernia is a lump or bulge either below or to the side of the belly button. The lump ...
- Valencia Higuera
Nov 11, 2021 · A spigelian hernia is a rare kind that's often difficult to diagnose. ... Any weakness of the abdominal wall muscles brought on by aging, for example, or disease; Constipation, with prolonged ...
Feb 29, 2024 · Spigelian hernias are an exceedingly rare type of ventral hernia. The defect in the case of a ventral hernia occurs between the transversus abdominis, extending from the cartilage of the ninth rib to the pubic tubercle, and the internal oblique aponeurosis [1]. Anatomically, the semilunar line is the border of these structures.
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Among these, spigelian hernias are an exceptionally rare subtype, representing 0.12% to 2% of all ventral hernias. This case study focuses on an 86-year-old female presenting with a ventral hernia, notably a spigelian hernia, lacking common predisposing factors.
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