A man with recurrent lower abdominal pain: Spigelian hernia
Kwok-Kay Yau1, Wing-Tai Siu, Ka-Leung Chan
1Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, SAR, China. yaukk1@ha.org.hk
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|February 22, 2008
Summary
Spigelian hernia (SH) causes rare abdominal pain, often missed by imaging. Laparoscopy offers a successful diagnostic and therapeutic solution for this challenging condition.
Area of Science:
- Gastroenterology and General Surgery
- Minimally Invasive Surgical Techniques
Background:
- Recurrent abdominal pain without a palpable mass presents a diagnostic challenge.
- Spigelian hernia (SH) is an uncommon cause of such pain, often overlooked by conventional imaging like ultrasound and CT scans.
- Small hernias that reduce spontaneously are particularly difficult to detect, even with advanced imaging.
Observation:
- A case of recurrent lower abdominal pain of unknown origin was investigated.
- Standard diagnostic methods, including imaging, failed to identify the cause.
- The patient presented with pain symptoms only, lacking a visible or palpable hernia.
Findings:
- Laparoscopic surgery was employed for both diagnosis and treatment.
- The laparoscopic approach successfully identified the underlying Spigelian hernia.
- The hernia was surgically repaired using a laparoscopic technique.
Implications:
- Laparoscopy is a valuable tool for diagnosing and managing difficult cases of Spigelian hernia.
- This approach is particularly effective when hernias are small or present without obvious physical signs.
- Laparoscopic surgery provides a dual diagnostic and therapeutic benefit for unexplained recurrent abdominal pain potentially caused by Spigelian hernia.
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