Spigelian hernia

Source: Wikipedia, the free encyclopedia.

A Spigelian is the type of

lower quadrant of the abdomen between an area of dense fibrous tissue and abdominal wall muscles causing a (Spigelian aponeurosis).[1]

It is the protuberance of

intestines or superficial fatty tissue through a hole causing a defect. As a result, it creates the movement of an organ or a loop of intestine in the weakened body space that it is not supposed to be in. It is at this separation (aponeurosis) in the ventral abdominal region, that herniation
most commonly occurs.

Spigelian hernia
Other namesLateral ventral hernia
strangulated is high.

Photograph by AfroBrazilian, distributed under a CC BY-SA 3.0 license.
Laparoscopic Hernia Surgery

Signs and symptoms

Individuals typically present with either intermittent pain, a lump or mass, all which are classic signs of a bowel obstruction.[2] The patient may have a protuberance when standing in an upright position although discomfort can sometimes be confused by its anatomical region for a peptic ulceration.[3] The bulge may be painful when the patient stretches but then goes away when they are lying down in a resting position.[4] However, a number of patients present with no obvious symptoms but vague tenderness along the area in which the Spigelian fascia is located.[5]

Diagnosis

anteriorly and medially to the inferior epigastric artery during Valsalva maneuver.[7] The diagnosis of a Spigelian hernia is traditionally difficult if only given a history and physical examination.[8] People who are good candidates for elective Spigelian hernia surgery, after receiving an initial diagnostic consultation by a licensed
medical professional, will be advised to see a physician to schedule surgery.

Treatment

The Spigelian hernia can be repaired by either an

strangulation.[9] Surgery is straightforward, with only larger defects requiring a mesh prosthesis. In contrast to the laparoscopic intraperitoneal onlay mesh plan of action there is a significant higher risk associated with complications and recurrence rates during the period following a surgical operation.[10] A Spigelian hernia becomes immediately operative once the risk of incarceration is confirmed.[citation needed] Today, a Spigelian hernia can be repaired by doing robotic laparoscopy and most patients are discharged on the same day. This novel, uncomplicated approach to small Spigelian hernias combines the benefits of laparoscopic localization, reduction, and closure without the morbidity and cost associated with foreign material.[11] Mesh-free laparoscopic suture repair is an uncomplicated approach to small Spigelian hernias combined with the benefits of a closure without the anguish and cost associated with foreign material.[6][12]

Eponym

Adriaan van den Spiegel was an anatomist at the University of Padua during the 17th century. He became a professor of surgery in 1619 and was the first to describe this rare hernia in 1627.[13] The history of the Spigelian hernia was acknowledged in 1645, twenty years after Spiegel's death. In 1764, almost a century later, the Flemish anatomist, Josef Klinkosch, was acknowledged for recognizing and describing a hernia located in the Spigelian fascia, and coined the term Spigelian hernia.[14]

Raveenthiran syndrome

Raveenthiran described a new syndrome in which Spigelian hernia and

cryptorchidism are testicular torsion, and its link to testicular cancer.[16]

References

External links