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Spigelian Hernia

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Spigelian Hernia

  • Epidemiology
  1. Rare Hernia
  • Pathophysiology
  1. Type of Ventral Hernia
  2. Hernia contains peritoneal sac and extreperitoneal fat
  3. Hernia of posterior lateral abdominal wall fascia
    1. Associated with posterior rectus sheath absence
    2. Perforates through linea semilunaris (semilunar line)
    3. Inferior and lateral to Umbilicus
      1. Edge of rectus sheath in mid-Abdomen
      2. Immediately below arcuate line
  4. Covering tissues
    1. Skin
    2. Subcutaneous fat
    3. External abdominal oblique muscle aponeurosis
  • Symptoms
  1. Asymptomatic until strangulation
  • Signs
  • Strangulation
  1. Examine with patient standing
  2. Tender mass in abdominal wall
  3. Localized to 3-5 cm above inguinal ligament
  • References
  1. Degowin (1987) Diagnostic Examination, p. 489-96
  2. Stevens (2013) Crit Dec Emerg Med 27(9): 2