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Pediatric lateral ventral (spigelian) hernias.

L Graivier, B Bronsther, N R Feins

    Southern Medical Journal
    |March 1, 1988
    PubMed
    Summary
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    Pediatric spigelian hernias are rare but can be missed. Early diagnosis and surgical repair are crucial for successful outcomes in children with this condition.

    Area of Science:

    • Pediatric Surgery
    • Abdominal Wall Defects
    • Hernia Surgery

    Background:

    • Lateral ventral (spigelian) hernias are uncommon in pediatric patients.
    • Diagnosis can be challenging due to lack of physician awareness and subtle presentation.
    • These hernias occur in the spigelian fascia, lateral to the rectus sheath, below the umbilicus.

    Purpose of the Study:

    • To increase awareness of pediatric spigelian hernias.
    • To report a series of pediatric cases.
    • To describe the diagnostic and surgical approach.

    Main Methods:

    • Review of pediatric spigelian hernia cases.
    • Clinical examination focusing on protrusion in the spigelian fascia.
    • Surgical repair using layered overlapping closure with nonabsorbable sutures.

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  • Preoperative marking of the defect while the child is awake and straining.
  • Main Results:

    • Nine pediatric cases are reported, doubling the previously recorded number to 18.
    • Successful surgical repair was achieved in all reported cases.
    • The technique of pre-operative marking proved essential for surgical localization.

    Conclusions:

    • Pediatric spigelian hernias require increased clinical suspicion for timely diagnosis.
    • Surgical repair is effective, with pre-operative marking being a critical step.
    • Further reporting of cases is needed to fully understand the incidence and management of pediatric spigelian hernias.