Incarcerated Spigelian hernia: A case report
Spigelian hernia is a rare partial abdominal wall defect in the transversus abdominus aponeurosis or Spigelian fascia. We here report the case of a patient with incarcerated greater omentum in a Spigelian hernia.
The patient presented with a six-hour history of nausea, constant abdominal pain, and a palpable mass in the left lower quadrant. Abdominal computed tomography revealed that omentum was strangulated in a Spigelian hernia that was successfully treated by plug and mesh repair. No recurrence has been observed during three-year follow-up.
In our case, plug and mesh repair was a safe and effective method of repairing an incarcerated Spigelian hernia with durability through three years of follow-up.
Available from: Sanoop Zachariah
- "Spigelian hernias have conventionally been repaired with an open surgical technique. Zacharakis et al.  have shown that the technique of plug and mesh repair is a safe and effective method of repairing an incarcerated Spigelian hernia. Minimally invasive techniques are becoming more and more popular. "
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ABSTRACT: Spigelian hernias are rare hernias, representing only about 1-2% of all abdominal hernias. An accurate preoperative diagnosis of this condition is often difficult because the physical presence of these hernias is often not demonstrable owing to its peculiar anatomic location. Many patients with Spigelian hernias, therefore, may have no obvious findings on clinical examination. The diagnosis is even trickier in obese patients wherein the hernia sac may lie in an intraparietal plane, masked by the abdominal subcutaneous fat. Here we describe a case of incarcerated Spigelian hernia where clinical and radiological findings were inconsistent and the accurate diagnosis was made by laparoscopy and was followed by a laparoscopic-assisted repair using an open anterior approach with an onlay mesh. We therefore feel that laparoscopy can be a useful tool for confirming the diagnosis and also for performing a definitive repair in doubtful cases of Spigelian hernias.
10/2011; 2011(5):491802. DOI:10.1155/2011/491802
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ABSTRACT: Incarcerated spigelian hernias are a rare cause of acute abdomen. The clinical diagnosis of incarcerated spigelian hernia can be a challenge in the absence of definite signs. Reported here is a case of a strangulated spigelian hernia that mimicked an appendicular mass and was discovered on CT scan of the abdomen and pelvis.
Southern Medical Journal 11/2007; 100(10):1037-8. DOI:10.1097/SMJ.0b013e3180f63336 · 0.93 Impact Factor
Southern Medical Journal 11/2007; 100(10):971-2. DOI:10.1097/SMJ.0b013e318151f925 · 0.93 Impact Factor
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