Incarcerated Spigelian hernia: a case report.
ABSTRACT 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.
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ABSTRACT: Spigelian hernia is a rare defect and represents 0.1 %-2 % of all abdominal wall hernias. There is a certain predisposition in females. Incarceration and strangulation are frequent complications. Spigelian hernia is the protrusion of a peritoneal sac or organ, or of preperitoneal fat, through a congenital or acquired defect in Spiegel's aponeurosis. The most frequent hernial contents are the greater omentum (39.1 %), small intestine (33.7 %) and colon (13.5 %). Other intra-saccular organs described include: gallbladder, stomach, Meckel's diverticulum, appendix, epiploic appendix, ovary, uterine leiomyoma, and saccular endometriosis. The hernial orifice is usually small, less than 2 cm in 57 % of the reviewed cases; it is oval or rounded in form with well-defined edges, which may facilitate hernia strangulation.Revista Hispanoamericana de Hernia. 10/2013; 1(4):165–166.
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ABSTRACT: Spigelian Hernia (SH) is a rare ventral hernia with a high incarceration and obstruction risk. The purpose of this study is to present our experience in diagnosis and treatment of this rare hernia entity. Sixteen patients underwent surgery for SH between 2000 and 2010. Analysis parameters included demographic data, location of defect, diagnostic methods, mode of surgery, mode of anesthesia and postoperative outcome. Mean follow-up was 98 months. The gender bias was 37.5 %: 62.5 % (man: woman) with mean age of 56 years. The SH was right-sided in 56.25 %, left-sided in 37.5 % and bilateral in 6.25 % of the cases. The preoperative diagnosis was correct in 25 % of the cases. Eight patients (50 %) underwent elective surgery, and the other 8 patients (50 %) underwent surgical treatment on emergency basis. Two patients underwent open hernia repair by primary suture, 13 patients underwent open mesh repair and one patient underwent a laparoscopic mesh repair. Neither a major hernia repair-related complication nor mortality could be registered. SH is a rare entity with a wide clinical spectrum and difficulties in preoperative diagnosis. Once the diagnosis of SH is established, a surgical treatment is indicated because of the high complication risk.Hernia 05/2012; 16(4):439-44. · 2.09 Impact Factor
- Iranian Red Crescent medical journal. 04/2012; 14(4):252-4.