It refers to a protrusion through a weakness between the rectus muscle and the semilunar line.
This type of abdominal hernias, also known as the Lateral Ventral Hernia, is a protrusion of preperitoneal fat or part of the organ through the Spigelian Fascia.
The term “Spigelian Fascia” refers to the combination of ventral aponeuroses, which consists of the external and internal abdominal oblique muscles, as well as the transverse abdominal muscle.
A Spigelian Hernia occurs along the Spigelian line, also known as the Semilunar line, which is a bilateral vertical curved line on the ventral abdominal wall that is parallel to the lateral edge of the rectus sheath.
This type of hernias is rare and occurs infrequently. While both male and female patients of all ages can suffer from this condition, it mostly affects men over their 50’s.
Causes
Just like other types of hernias, the Spigelian Hernia is the result of a weakness in the muscles of the abdominal wall.
This weakened area allows organs and tissues, preperitoneal fat in most cases, to protrude through.
Different factors can lead to the development of a Spigelian Hernia. Some of them may be related to inherited conditions, but medical experts admit such cases rarely occur.
In other cases, the cause of this hernia is related to other conditions that can potentially trigger chronic coughings, such as Bronchitis or the Chronic obstructive pulmonary disease (COPD).
Such diseases result in increased intra-abdominal pressure, which leads to the development of the protrusion that characterizes a Spigelian Hernia.
Another condition that can cause a Spigelian Hernia is Ascites, which consists of the accumulation of fluid in the abdominal cavity, which can create a weakness in the Spigelian Fascia.
Other possible causes of this type of hernias are not related to diseases.
For example, people who overexert themselves when performing physical tasks such a heavy-lifting may strain their muscles to the point of weakening the abdominal wall.
Other patients develop a Spigelian Hernia after experiencing physical trauma.
Symptoms of Spigelian Hernia
The Spigelian Hernia does not present unique or singular symptomatology. That is why the signs usually vary from patient to patient.
More often than not, the protrusion is difficult to notice due to its location under the external oblique muscle layers. But, in cases of skinny patients, people may be able to see a bulge in the affected area.
Most patients with a Spigelian Hernia experience pain or discomfort at the abdominal region, especially when exerting physical force or straining the muscles of the abdomen.
Other potential symptoms include sudden changes in bowel function, such as constipation; and in some cases, bloody stools.
This condition can disrupt or alter the functions of the bowel or other vital organs, which is why people who get diagnosed with a Spigelian Hernia should get treated as soon as possible.
Diagnosis
This condition doesn’t occur very often. In fact, it only represents the 1% of all cases of hernias.
That is why the diagnosis of this type of hernias is still up to debate among medical experts.
Several doctors usually order imaging tests to locate the protrusion. Some of them include:
- X-rays, which consists of using small amounts of high-energy radiation to produce pictures of the organs, tissues, and bones inside the body.
- Ultrasound or Sonography, a diagnostic medical procedure that uses high-frequency sound waves to produce dynamic visual images of the structures inside the body.
- Computed Tomography (CT) scan, which is an imaging procedure that uses sophisticated x-ray technology and a computer produce cross-sectional images of the body.
If despite using these tools the diagnosis remains unclear, yet medical experts suspect that a hernia is there, they could carry out an exploratory surgery to both locate and fix the issue.
Spigelian Hernia Treatment
The most typical way to deal with this condition is through a Laparoscopic Hernia Repair surgery.
However, doctors will decide whether or not carrying out this procedure based on the size of the protrusion and the severity of the pain it causes.
The Laparoscopic Hernia Repair is a minimally invasive surgical procedure that uses a tube and a camera introduced into the body through a small incision.
The camera will help the doctors locate the herniated section of the abdominal wall and repair it.
