scholarly journals Laparoscopic Diagnosis of Incarcerated “Spigelian Hernia”: Report of a Case and Review of the Literature

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Sanoop Koshy Zachariah ◽  
Priya Jose
Keyword(s):  
Subcutaneous Fat ◽  
Spigelian Hernia ◽  
Radiological Findings ◽  
Hernia Sac ◽  
Abdominal Hernias ◽  
Physical Presence ◽  
Accurate Preoperative Diagnosis ◽  
Definitive Repair ◽  
Onlay Mesh ◽  
Laparoscopic Assisted

Spigelian hernias are rare hernias, representing only about 1-2% of all abdominal hernias. An accurate preoperative diagnosis of this condition is often difficult because the physical presence of these hernias is often not demonstrable owing to its peculiar anatomic location. Many patients with Spigelian hernias, therefore, may have no obvious findings on clinical examination. The diagnosis is even trickier in obese patients wherein the hernia sac may lie in an intraparietal plane, masked by the abdominal subcutaneous fat. Here we describe a case of incarcerated Spigelian hernia where clinical and radiological findings were inconsistent and the accurate diagnosis was made by laparoscopy and was followed by a laparoscopic-assisted repair using an open anterior approach with an onlay mesh. We therefore feel that laparoscopy can be a useful tool for confirming the diagnosis and also for performing a definitive repair in doubtful cases of Spigelian hernias.

scholarly journals Large Strangulated Spigelian Hernia: Management of an Uncommon Presentation of Abdominal Hernias in Central Uganda

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Wasingya Lucien ◽  
Franck Katembo Sikakulya ◽  
Kisembo Peter ◽  
Atwijukire Vincent
Keyword(s):  
Abdominal Wall Defect ◽  
Fluid Collection ◽  
Rare Condition ◽  
Abdominal Distension ◽  
Abdominal Ultrasound ◽  
Spigelian Hernia ◽  
Large Defect ◽  
Hernia Sac ◽  
Abdominal Hernias ◽  
Uncommon Presentation

Background. Spigelian hernia is an uncommon presentation of abdominal hernias with 0.1-2%. We report a case of a large strangulated Spigelian hernia, an uncommon presentation of abdominal hernias, and its management in a health facility in Central Uganda. Case Presentation. A 76-year-old female presented with a 2-day history of colicky abdominal pain, bilious vomiting, and abdominal distension. On abdominal ultrasound scan, an abdominal wall defect measuring 4.45 cm with herniated bowel loops in the left anterior abdominal region with mild fluid collection in the hernia sac was seen. Conservative management for intestinal obstruction which included putting the patient on nil per os, NG tube decompression, and soapy enema was instituted, and surgery was done on the second day of admission. Intraoperatively, using a Rutherford-Morrison incision, we found a large defect at the Spigelian aponeurosis, with an inflamed sac protruding. The Spigelian hernia was repaired with a mesh under layers. The patient recovered uneventfully and was discharged 10 days after surgery. Conclusion. Clinicians and especially general surgeons might be aware of this rare condition in most of the anterior abdominal swellings. Strangulation is the commonest complication of Spigelian hernia, and surgical management remains the mainstay of its treatment.

scholarly journals VP021 A WAY TO TREAT SPIGELIAN HERNIA

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Bruno Barbosa ◽  
Raquel Pereira ◽  
Cesar Prudente ◽  
Maria Joao Diogo ◽  
Carlos Casimiro ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Repair ◽  
Surgical Repair ◽  
Laparoscopic Approach ◽  
Spigelian Hernia ◽  
Laparoscopic Technique ◽  
Open Surgical Repair ◽  
Intraperitoneal Route ◽  
Abdominal Hernias

Abstract Aim “Spigelian hernia is uncommon and accounts for only 0.12–2% of all abdominal hernias. It is mandatory to perform surgical correction and in recent years the laparoscopic approach is gaining ground. The authors pretend to demonstrate a video of an outpatient laparoscopic repair of Spigelian hernia.” Material and Methods “53-year-old woman with a left Spigelian hernia referred to laparoscopic repair via intraperitoneal approach.” Results “The patient was submitted to laparoscopic correction with a Ventralex® mesh. The surgery went without any complication and under 30 minutes. A few hours after the surgery, the patient was discharged. In the follow-up appointment, the patient had no complaints or evidence of recurrence.” Conclusions “Spigelian hernias are rare and have a mandatory surgical indication. Traditionally, open surgical repair is most commonly used. However, laparoscopic approach is becoming increasingly popular since it allows faster recovery, shorter hospital stay, and less pain, with no commitment to recurrence. Currently, there are no studies that demonstrate the superiority of a laparoscopic technique (intraperitoneal, TAPP or TEP). The intraperitoneal route is a simple, faster, and easily reproducible approach.”

Outcomes of Laparoscopic-Assisted, Open Umbilical Hernia Repair

2020 ◽  
Vol 86 (8) ◽  
pp. 1001-1004
Author(s):  
Jenny M. Shao ◽  
Sharbel A. Elhage ◽  
Tanu Prasad ◽  
Paul D. Colavita ◽  
Vedra A. Augenstein ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Umbilical Hernia ◽  
Patient Characteristics ◽  
Radiographic Examination ◽  
Intraperitoneal Onlay Mesh ◽  
Institutional Review ◽  
Umbilical Hernia Repair ◽  
Onlay Mesh ◽  
Laparoscopic Assisted

Umbilical hernia repair (UHR) is one of the most commonly performed hernia operations with reported recurrence rate from 1% to 54%. Our aim was to describe an open, laparoscopic-assisted (OLA) technique and its outcome in an institutional review board-approved prospective study at a tertiary hernia center from 2008 to 2019. All patients underwent a standard periumbilical incision, open dissection of the hernia, and closure of the fascial defect with laparoscopic intraperitoneal onlay mesh (IPOM) fixation with permanent tacks. A total of 186 patients were identified who underwent an OLA UHR repair. Patient characteristics are as follows: average age 52.8 ± 12.5 years, male gender 79.6%, body mass index 31.4 ± 8.0 kg/m2, and average hernia defect size of 2.8 ± 4.8 cm2. Forty-one (22.0%) patients had previous failed repair. Sixty-nine (37.1%) patients had another procedure performed at the time of the UHR, most commonly a laparoscopic transabdominal inguinal hernia repair (58%). The mean operative time was 87.3 ± 51.2 minutes, but only 63.9 ± 31.9 minutes for patients undergoing an OLA repair. There were no recurrences (0%) on abdominal physical or radiographic examination with an average follow-up of 16.5 ± 17.7 months. Postoperative complications included wound erythema (2.7%), hematomas (1.1%), seromas (2.7%), and 4.3% received postoperative oral antibiotics. One person was readmitted for seroma drainage, and another required reoperation for small bowel obstruction unrelated to the hernia repair. One patient had chronic pain requiring tack removal. With moderate follow-up, an OLA UHR with mesh appears to be a durable repair with favorable results, including those patients with recurrent hernias.

SPIGELIAN HERNIA VARIOUS PRESENTATION AND MANAGEMENT- A CASE SERIES

2021 ◽  
pp. 6-8
Author(s):  
B. Santhi ◽  
M. Uma ◽  
Surya. R
Keyword(s):  
Computed Tomography ◽  
Surgical Technique ◽  
Clinical Presentation ◽  
Case Series ◽  
Spigelian Hernia ◽  
Operative Techniques ◽  
Radiological Investigation ◽  
Abdominal Hernias ◽  
Consistent Feature ◽  
High Index Of Suspicion

BACKGROUND: Spigelian hernia is rare and requires high index of suspicion. Given the case of inconsistent ndings and signs the diagnosis of spigelian hernia presents with great difculties than its treatment. Incidence of spigelian hernia ranges from 0.1% to 2% of all abdominal hernias AIM: Aim of this case series is to analyze epidemiological aspects, clinical presentation, challenges in diagnosis, surgical technique characteristics, morbidities and hospital stay MATERIALS AND METHODS: A total number of 4 patients who had undergone surgery for spigelian hernia for a period of 6 months from the month of Jan to June 2021 in the dept of general surgery in KMCH were studied. All 4 cases have been analyzed in this study period and followed up until discharge from the hospital. RESULTS: This case series consisted of 4 cases. All cases presented with pain. Only 2 among 4 cases presented with swelling. Denitive diagnosis of all cases could be done only by CT. Out of these 1 was taken up as emergency.Intraoperatively 3 cases were interstitial and 1 was subcutaneous type. All 4 cases were treated by open surgical technique and by placing mesh at different planes CONCLUSION: Diagnosis of spigelian hernia presents with great difculties and hence one must be aware of the clinical presentation. Pain is the consistent feature of all hernias and only occasionally swelling is present which may mislead easily. Computed tomography of abdomen and pelvis still prevails as the denitive radiological investigation in the diagnosis of spigelian hernia. There are many planes at which mesh can be placed for repair where the operative techniques vary. Though the outcome was good in all four cases discussed here, the post operative complication and duration of stay was considerably less when the mesh was placed in the intermuscular plane.

scholarly journals Endometriosis in a Spigelian Hernia Sac: An Unexpected Finding

2015 ◽  
Vol 100 (1) ◽  
pp. 109-111 ◽  
Author(s):  
Demetrios Moris ◽  
Adamantios Michalinos ◽  
Spiridon Vernadakis
Keyword(s):  
Spigelian Hernia ◽  
Unexpected Finding ◽  
Lower Quadrant ◽  
Hernia Sac ◽  
Endometrial Cells ◽  
Persistent Abdominal Pain ◽  
Wall Mass ◽  
Rare Diagnosis ◽  
Tomography Scan ◽  
Previous Cesarean

Abstract Describes the existence of endometrioma in a spigelian hernia sac. Spigelian Hernia is a rare ventral hernia, presenting difficulties in diagnosis and carrying a high incarceration and obstruction risk. Endometriomas occur due to implantation of endometrial cells into a surgical wound, most often after a cesarean delivery. A 37-year-old woman presented to our department with persistent abdominal pain, exacerbating during menses, and vomiting for 2 days. Physical examination revealed a mass-like lesion in the border between the left-upper and left-lower quadrant. Ultrasound examination was inconclusive and a computed tomography scan of the abdomen revealed an abdominal wall mass. During surgery, a spigelian hernia was found 5 to 7 cm above a previous cesarean incision. Tissue like “chocolate cysts” was present at the hernia sac. Hernia was repaired while tissue was excised and sent for histological examination that confirmed the diagnosis. Spigelian hernia is a hernia presenting difficulties in diagnosis and treatment. Endometrioma in a spigelian hernia sac is a rare diagnosis, confirmed only histologically. Clinical suspicion can be posed only through symptoms and thorough investigation.

Sign in / Sign up

Export Citation Format

Share Document