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A spigelian hernia in an infant
T Azuma1, S Nakamura, G Hatakeyama
1Department of Surgery, Children's Medical Center of Osake City, Japan.
Insights
This report details a rare infantile Spigelian hernia in a Japanese infant. The study found no link between the hernia and prior meningomyelocele treatment or ventriculo-peritoneal shunting.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Abnormalities
Background:
- Spigelian hernias are rare abdominal wall defects, particularly in infants.
- Previous reports indicate causes such as trauma or abdominal surgery, but many cases lack evident etiology.
- Infantile Spigelian hernias are exceptionally uncommon, with limited documented cases globally.
Observation:
- A two-month-old Japanese infant developed a left-sided Spigelian hernia during recovery from meningomyelocele treatment and ventriculo-peritoneal (V-P) shunting.
- This represents the first reported case of infantile Spigelian hernia in Japan.
- The patient's medical history included meningomyelocele and V-P shunting.
Findings:
- The study questions a direct cause-and-effect relationship between the meningomyelocele treatment, including V-P shunting, and the development of the Spigelian hernia.
- No evident cause was identified for the Spigelian hernia in this infant, despite the preceding neurosurgery.
- The rarity of infantile Spigelian hernias is highlighted, with only 20 cases reported worldwide in children.
Implications:
- This case contributes to the limited understanding of infantile Spigelian hernias and their potential, albeit unlikely, associations with prior medical interventions.
- It underscores the importance of considering rare diagnoses even in the context of known medical conditions and procedures.
- Further investigation into the etiology of infantile Spigelian hernias may be warranted, particularly in diverse geographical populations like Japan.
Abstract:
The case of a two-month old Japanese girl with a left side Spigelian hernia that developed during the course of recovery from the surgical treatment of a meningomyelocele and ventriculo-peritoneal shunting (V-P shunting) is reported on. At this time, to our knowledge, 20 cases involving infants and children have been reported on in world-wide medical literature. Of these cases, 4 cases were caused by trauma, 1 by abdominal surgery, and the others had no evident causes. Our patient had a meningomyelocele, and underwent a V-P shunting. However, a cause and effect relationship between the Spigelian hernia and the treatment of the meningomyelocele followed by V-P shunting is inconceivable. We doubt any relationship between the preceding neurosurgery and the development of the hernia. This is the first case of infantile Spigelian hernia reported on in Japan.