spigelian hernia
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Epidemiology
- rare, 1000 cases as of 2007
Pathology
- occurs along sumilunar line, caudal most extent of posterior rectus sheath
- anatomic location weak because of absence of posterior sheath behind rectus muscle
- peritoneal fat emerges through defect in Spigelian fascia & brings peritoneum with it
Clinical manifestations
- swelling in mid to lower abdomen just lateral to rectus muscle
- pain or tenderness, localized
- hernia usually reducible in reducible in supine
Radiology
- ultrasound is imaging mode of choice
- computed tomography
Management
- surgery mandatory, open vs laparascopic
More general terms
References
- ↑ UpToDate 15.3
- ↑ Skandalakis PN et al, Spigelian hernia: surgical anatomy, embryology, and technique of repair. AM J Surg 2006, 72:42 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16494181
- ↑ Mufid MM et al, Spigelian hernia: diagnosis by high-resolution real-time sonography. J Ultrasound Med 1997, 16:183 PMID: https://www.ncbi.nlm.nih.gov/pubmed/9166814
- ↑ Shenouda NF etl al, Evaluation of spigelian hernia by CT. J Comput Assis Tomogr 1990, 14:77 PMID: https://www.ncbi.nlm.nih.gov/pubmed/2308159
- ↑ Larson DW and Farley DR Spigelian hernias: repair and outcome for 81 patients. World J Surg 2002, 26:1377 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12205553
- ↑ Morena-Egea A et al, Open vs laparoscopic repair of spigelian hernia: a prospective randomized trial. Arch Surg 2002, 137:1266 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12413315