Spigelian hernia: An unusual presentation of an uncommon entity
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Hellenic Journal of Surgery (2013) 85:5, 333-336
Spigelian Hernia: An Unusual Presentation οf an Uncommon Entity Arghya Basu, Dawood Khan, Utpal De, Anshuman Poddar, Ujjwal Parui
Abstract Introduction Spigelian hernia (SH) is an uncommon defect of the abdominal wall that occurs through the spigelian
fascia. SH has varied, non-specific, dubious clinical features which makes diagnosis extremely difficult at times. Pain is common and is invariably associated with the narrow neck of the sac; atypically, our patient had no history of pain at any time. Case Report Herein, we present the case of an extremely rare variety of hernia in an 83-year-old male patient. Clinical
examination revealed globular, subcutaneous, soft, reducible swelling measuring 6 x 8 cm over the left iliac fossa of this patient with visible cough impulse. Ultrasonography (USG) showed a 2.5 x 2.5 cm muscle defect in the anterior abdominal wall above and lateral to the left inguinal region. Discussion SH is a rare form of ventral hernia. The commonest presenting feature is pain, or an anterior abdominal wall lump or incarceration. Real-time USG can easily detect the defect and demonstrate the cough impulse. Both open and laparoscopic approaches have been elected for repair. Conclusion Radiological investigations must be undertaken, and surgery should always be performed to avoid risk of
strangulation or incarceration of the hernia. Although laparoscopic repair has gained popularity, the open approach remains the gold standard in emergency situations. Key words Giant sigmoid diverticulum, diverticular disease, colon surgery
Introduction Spigelian Hernia (SH), [otherwise known as a spontaneous lateral ventral hernia, hernia of the semilunar line, hernia through the conjoined tendon, or interstitial ventral hernia], occurs through the spigelian fascia, an aponeurotic Arghya Basu MBBS (HONS.), MS (General Surgery) PGT, Dept. of General Surgery, Medical College, Kolkata, West Bengal, India Dawood Khan MBBS, MS (General Surgery), Asst. Prof. of Surgery, Dept. of General Surgery, Medical College, Kolkata, West Bengal, India Utpal De MBBS, MS (General Surgery), Professor of Surgery, Dept. of General Surgery, Medical College, Kolkata, West Bengal, India Anshuman Poddar MBBS, MS (General Surgery) PGT, Dept. of General Surgery, Medical College, Kolkata, West Bengal, India Ujjwal Parui Mbbs, Ms (General Surgery) Pgt, Dept. of General Surgery, Medical College, Kolkata, West Bengal, India Corresponding author: Arghya Basu, 26A, Keshab Chandra Sen Street. Near College Street Bata. Behind Jawahar Cinema, Kolkata, West Bengal, India, Postal Code - 700009 Phone Number: +919051202232, +919477116161 E-mail: [email protected], [email protected] Received 16 May 2013; Accepted 24 June 2013
Hellenic Journal of Surgery 85
layer between the lateral edge of the rectus abdominis muscle and the semilunar line [1]. It was first reported by Josef T.K. Linkoschin in 1764, but was named after Adrian Van Der Spieghel who had described the anatomy of the semiluna
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