Spigelian Hernia
Spigelian Hernias are rare hernias that occur when there is a slit or defect in the fibrous line just lateral to the rectus abdominal (“6-pack”) muscles. This fibrous line, also called the Spigelian Line, is most vulnerable from the level of the umbilicus to 6 cm below this point. This is where the abdominal wall is at its greatest circumference and highest intra-abdominal pressure. Any increase in pressure can result in stretching of this fibrous line and formation of any rents or tears that can enable fat, small bowel or other organs to enter these spaces. Over time these small holes can increase in size allowing these organs to enter the hole(s). As the small defects become larger, they often spread laterally into the space between the external oblique (EO) and internal oblique (IO) muscles.
How do I know if I have a Spigelian Hernia?
The most common symptoms are pain or a small lump along the Spigelian Line. They can also present with complications related to the organs caught in the hernia. For example if the Spigelian hernia has small bowel in it this can cause a bowel obstruction. The diagnosis is often made with radiological imaging such as ultrasound or CT scans of the abdomen.
Treatment
Once a Spigelian hernia has been diagnosed, or is strongly suspected from your history, you should be referred to a General or Hernia Surgeon to discuss the best treatment option. The only way to fix a Spigelian hernia is with an operation and this may be done with an open operation or a key-hole (laparoscopic) operation depending on what is the right operation for you. If you are having serious complications from your Spigelian Hernia, such as obstruction, incarceration or strangulation of your bowel you should speak to your GP, Hernia Surgeon or present to an Emergency Department for urgent surgical care.