Lateral ventral (spigelian) hernias in infants and children

Lateral ventral hernias are found in the spigelian fascia lateral to the junction of the arcuate and semilunar lines and below the level of the umbilicus. Three cases are reported in infants and children. Diagnosis depends on finding an unusual mass on the anterior abdominal wall and palpation of the rim of the hernia defect upon reduction of the mass. A spigelian hernia may be misdiagnosed easily if the examiner is unaware that it can occur in childhood. The edge of the defect must be outlined while the child is straining, prior to induction of anesthesia, as the rim may be difficult to find when the patient is asleep.