Spigelian hernia is a rare hernia located in the abdominal wall, slightly to the side of the upper abdomen. A spigelian hernia is repaired in the same way as most other hernias by using tension-free mesh reinforcement. Symptoms of a spigelian hernia can include a bulge appearing to the side and below your navel and a certain amount of discomfort that may become more painful when lifting heavy objects or through coughing.
Cause Of Spigelian Hernia
This type of hernia protrudes through a weakness between the muscle fibres of the abdominal wall. Factors that can contribute to causing a spigelian hernia include obesity, sports activity, coughing and heavy lifting.
Figure 1. Anatomy of abdominal wall.
1: Linea semilunaris (spigelian); 2: Rectus abdominis muscle;
3: Transversus abdominal muscle; 4: Spigelian aponeurosis; 5: Linea semicircularis
Symptoms Of Spigelian Hernia
A spigelian hernia can be difficult to diagnose due to the lack of obvious symptoms. Below are some of the known symptoms.
- Poor bowel function
- Dull ache in the abdominal area
- Recurring pain especially during activity
Diagnosis Of Spigelian Hernia
Spigelian hernias tend to have a narrow neck and are usually small and often start with pain or discomfort in the area – lower abdominal wall on the right or the left. Below the level of the umbilicus or navel. The bulge of the hernia is not often seen or felt (by doctors) as it lies beneath the aponeurosis (tendon like covering sheath) of the external oblique muscle. Confirmation of the diagnosis may require ultrasound or CT-scan.
Treatment Of Spigelian Hernia
Surgery under local or general anaesthetic is usually required to treat this type of hernia as it can be prone to strangulation. Typical surgery methods include tension-free open mesh that has been perfected by London Hernia consultants over many years.
Many hernias do not hurt so the temptation is to leave them and get on with life. However, failing to get medical advice can be damaging and is not recommended. If left the hernia will grow and discomfort and pain, even if negligible to start with, will intensify.