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Spigelian herniae: presentation, diagnosis and treatment

D Y Artioukh1, S J Walker

  • 1Department of Surgery, Whiston Hospital, Prescot, Merseyside, UK.

Journal of the Royal College of Surgeons of Edinburgh
|August 1, 1996
PubMed
Summary

Spigelian hernia, a rare abdominal wall defect, often presents with delayed diagnosis and treatment. This study highlights diagnostic challenges and common presentations in 19 patients, emphasizing the need for increased clinical suspicion.

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Area of Science:

  • Abdominal surgery
  • Gastroenterology
  • Surgical anatomy

Background:

  • Spigelian hernia is an uncommon abdominal wall defect.
  • Diagnosis can be challenging, leading to delayed treatment.
  • Understanding its presentation and anatomical variations is crucial for surgical management.

Purpose of the Study:

  • To present a personal series of patients with spigelian hernia.
  • To describe the clinical presentation, surgical findings, and pre-operative diagnostic accuracy.
  • To identify predisposing factors and treatment delays.

Main Methods:

  • Retrospective review of 19 patients diagnosed with spigelian hernia.
  • Analysis of patient demographics, clinical presentation, surgical findings, and pre-operative diagnosis.
  • Documentation of hernia sac contents and anatomical defect location.

Main Results:

  • 19 patients (mean age 62.4 years) with spigelian hernia were analyzed.
  • Defect location varied, with most between oblique muscle layers (83.3%).
  • Common hernia sac contents included small bowel (33.3%) and omentum (27.8%); 21.1% presented acutely.
  • Pre-operative diagnosis was suspected in only 52.9%, with frequent treatment delays.

Conclusions:

  • Spigelian hernias often present with subtle or atypical symptoms, leading to diagnostic delays.
  • Increased clinical awareness and diagnostic imaging may improve pre-operative identification.
  • Prompt surgical intervention is recommended once diagnosed to prevent complications.

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