Spigelian hernia: A rare case presentation and review of literature
Gyaneswhor Shrestha1, Ibrahim Adhil1, Sharad Bahadur Adhikari1
1Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal.
Introduction And Importance:
Spigelian hernias are rare abdominal wall defects that occur at the semilunar line lateral to the rectus abdominis muscle. They are located between the muscular layers of the abdominal wall and can be easily overlooked because of abdominal obesity. They are difficult to diagnose because of their location and vague symptoms. The diagnosis has been considerably aided by the introduction of ultrasonography and Computed Tomography.
Case Presentation:
We report a case of 60 years old male who presented with swelling and vague abdominal discomfort in the right lower abdomen and was diagnosed with the help of CT scan in prone position. The patient underwent transabdominal preperitoneal repair laparoscopically. His recovery was uneventful.
Clinical Discussion:
Spigelian hernia constitutes about 0.12 to 0.2 % of all abdominal hernias. It commonly occurs in semilunaris line, well-defined defect in the Spigelian aponeurosis at the "Spigelian hernia" belt. Ultrasound scanning is recommended as first line imaging investigation in suspected case. Prompt surgical repair is recommended for spigelian hernia to prevent subsequent strangulation.
Conclusion:
Since spigelian hernia is a rare entity a high index of suspicion is required for accurate diagnosis. Once diagnosis is made, operative management is required to prevent incarceration.
