[The Spigelian hernia: missed? rare? puzzling diagnosis?]

Area of Science:

• Abdominal Surgery
• Gastroenterology
• Surgical Diagnostics

Background:

• Spigelian hernias are uncommon abdominal wall defects.
• Accurate pre-operative diagnosis can be challenging.
• Differentiating hernias from other causes of abdominal pain is crucial.

Purpose of the Study:

• To evaluate the diagnostic accuracy of pre-operative assessments for Spigelian hernias.
• To analyze the surgical outcomes of patients treated for suspected Spigelian hernias.
• To compare results between confirmed Spigelian hernias and other intra-abdominal pathologies.

Main Methods:

• Retrospective review of 24 patients operated for suspected Spigelian hernia over six years.
• Intraoperative verification of hernia presence.
• Postoperative follow-up of 22 patients for 1-6 years.

Main Results:

• Spigelian hernia confirmed intraoperatively in 12 patients (50%).
• The other 12 patients (50%) had no hernia, but other findings explained their symptoms.
• Patients with confirmed Spigelian hernias generally had good postoperative outcomes.
• Patients without confirmed hernias but with other conditions reported less satisfactory results.

Conclusions:

• Clinical diagnosis of Spigelian hernia has limitations, with a 50% intraoperative confirmation rate in this series.
• Surgical intervention for confirmed Spigelian hernias yields favorable outcomes.
• Non-hernia related findings in patients with suspected Spigelian hernia require careful consideration for optimal patient management.