A Rare Case Report of Spigelian Hernia

P Chiranjeevi Reddy, A Ravitheja, K Jyothirmayee, K Bhaskar

Abstract


Introduction: spigelian hernias (SH) represent 0.12–2.4% of all abdominal wall hernias. Its diagnosis is elusive and requires a high level of conjecture given the disease rarity, vague-associated abdominal complaints and frequent lack of consistent physical findings. Presentation of case: a 40-year-old woman presented with a history of chronic pain in the right lower side of the abdomen. The patient was treated for several diseases with no relief of symptoms. Abdominal ultrasound showed an SH in the lower right abdomen and surgery was scheduled for treatment.

Discussion: an SH is generally an inter-parietal hernia, meaning that the pre-peritoneal fat and the hernia sac penetrate the transversus abdominis and internal oblique muscles but remain behind the external oblique aponeurosis. In most of the patients the lack of clinical signs demands the importance of radiological investigation especially high grade which is. That’s the importance of the high grade of suspicion of the disease during the physical exam. The surgical repair is necessary due to the high risk of incarceration-related complications, which can occur in up to 21% of cases.

Conclusion: diagnostics and history of abdominal pain is important in diagnosing SH as it cause of lower abdominal pain to prompt indicate surgical repair and provide the patient’s symptom relief. Also the type of repair is dependent on the surgeon’s choice and also the means available in each centre.


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References


Salameh JR. Primary and unusual abdominal wall hernias. Surg Clin North Am 2008;88:45–60.

Mittal T, Kumar V, Khullar R, Sharma A, Soni V, Baijal M, et al. Diagnosis and management of spigelian hernia: a review of literature and our experience. J Min Access Surg 2008;4:95–8.

Leme PLS, Carvalho DLM, Botter M, Höhne OMP, Salinas JA, Viana AT. Anatomical study of the ventral abdominal wall in cadaver and spigelian hernia. Revista do Colégio Brasileiro de Cirurgiões 2001;28(6):414–20.

Campanelli G, Pettinari D, Nicolosi FM. Spigelian hernia. Hernia 2005; 9:3–5.

Jamadar DA, Jacobson JA, Morag Y, Girish G, Ebrahim F, Gest T, et al. Sonography of inguinal region hernias. Am J Roentgenol 2006;187:185–90.

Bell RL, Longo WE. Images for surgeons/spigelian hernia. J Am Coll Surg 2004;199(1):161.

Malazgirt Z, Tpogul K, Sokmen S. Spigelian hernias: a prospective analysis of baseline parameters and surgical outcome of 34 consecutive patients. Hernia 2006;10:326–30.

Vos DI, Scheltinga MRM. Incidence and outcome of surgical repair of spigelian hernia. Brit J Surg 2004;91:640–4.

Garcia FE, Garriga LL, Vilaseca RM, Rafecas-Renau A. Hernia de Spiegel incarcerada. CirugíaEspa˜nola 2009;85(2):114.

Bilsel Y, Abci I. The search for ideal hernia repair; mesh materials and types. Int J Surg 2012, http://dx.doi.org/10.1016/j.ijsu.2012.05.002.

Sajid MS, Leaver C, Baig MK, Sains P. Systematic review and meta-analysis of the use of lightweight versus heavyweight mesh in open inguinal hernia repair. Brit J Surg 2012;99:29–37.

Pierides G, Scheinin T, Remes V, Hermunen K, Vironen J. Randomized comparison of self-fixating and sutured mesh in open inguinal hernia repair. Brit J Surg 2012;99:630–6.

Campaneli G, Pascual MH, Hoeferlin A, Rosenberg J, Champault G, Kingsnorth A, et al. Randomized, controlled, blinded trial of Tisseel/Tissucol for mesh fixation in patients undergoing Lichtenstein technique for primary inguinal hernia repair/results of the TIMELI trial. Ann Surg 2012;255:650–7.

Sajid MS, Ladwa N, Kalra L, Hutson K, Sains P, Baig MK. A meta-analysis examining the use of tacker fixation versus no-fixation of mesh in laparoscopic inguinal hernia repair. Int J Surg 2012;10:224–31.

Köckerling F, Chowbey P, Lomanto D [Letter to Editor]. A meta-analysis examining the use of tacker fixation versus no-fixation in laparoscopic inguinal hernia repair. Int J Surg 2012, http://dx.doi.org/10.1016/j.ijsu.2012.04.022




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