A case of incarcerated spigelian hernia causing small bowel obstruction

Authors

  • Ravi Kumar Sabu Murugesan Institute of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India
  • Kannan Ross Institute of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India
  • Joyce Prabakar Institute of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20205392

Keywords:

Spigelian hernia, Intestinal obstruction, Abdominal pain, Rectus sheath, Semilunar line

Abstract

Spigelian hernias are rare anterior abdominal wall hernias in which the defect occur at the semilunar line lateral to rectus abdominis muscle. It mostly occurs in the lower half as posterior sheath is deficient in that region. Spigelian hernias are rare and moreover it is difficult to diagnose clinically. It constitutes about 0.12% of abdominal wall hernias. Even though it is rare, it is more prone for complications. It affects both sexes and sides equally. It is a diagnostic difficulty especially in obese patients as in our case where physical examination will often be inconclusive. Majority of the spigelian hernias are diagnosed intra operatively. Here in this case report, we present a case of obese 48 years old female who presented with abdominal pain and signs of intestinal obstruction which was found out to be an incarcerated spigelian hernia. Recently laparoscopic repair has been found to be safe and effective.

References

Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P. Spigelian hernia: surgical anatomy, embryology, and technique of repair. Am Surg. 2006;72:42-8.

Chowbey PK, Sharma A, Khullar R, Mann V, Baijal M, Vashistha A. Laparoscopic ventral hernia repair. J Laparoendosc Adv Surg Tech A. 2000;10(2):79-84.

Carter JE, Mizes C. Laparoscopic diagnosis and repair of spigelian hernia: report of a case and technique. Am J Obstet Gynecol. 1992;167(1):77-8.

Mittal T, Kumar V, Khullar R, Sharma A, Soni V, Baijal M et al. Diagnosis and management of Spigelian hernia: A review of literature and our experience. J Minim Access Surg. 2008;4(4):95-8.

Sardarian H, Maleki I, Mortazian M, Jafari R, Tayebi P, Saberifiroozi M. A rare cause of small bowel obstruction in adults: left paraduodenal internal hernia. Middle East J Dig Dis. 2012;4(2):125-9.

Pujahari AK. Decision Making in Bowel Obstruction: A Review. J Clin Diagn Res. 2016;10(11):PE07-12.

Shih YC, Sun HP. Spigelian hernia showing itself as a left lower abdominal mass. Form J Surg. 2014;47(2):78-81.

Ribeiro EA, Cruz RJ Jr, Moreira SM. Intestinal obstruction induced by a giant incarcerated Spigelian hernia: case report and review of the literature. Sao Paulo Med J. 2005;123(3):148-50.

George R, Vasanthi MS, Prasad K, Prasad A. Spigelian hernia: rare so, beware! Int Surg J. 2014;1:50-2.

Lucien W, Sikakulya FK, Peter K, Vincent A. Large Strangulated Spigelian Hernia: Management of an Uncommon Presentation of Abdominal Hernias in Central Uganda. Case Reports in Surgery. 2019;2019(4):8474730.

Seetahal S. Insidious abdominal pain? consider spigelian hernia. A case report. Surg Rehabil. 2018;

Larson DW, Farley DR. Spigelian hernias: repair and outcome for 81 patients. World J Surg. 2002;26:1277-81.

Spigelian hernia. Available at: https://radiopaedia.org/articles/spigelian-hernia-1. Accessed on 07 September 2020.

Celdrán A, Señaris J, Mañas J, Frieyro O. The open mesh repair of Spigelian hernia. Am J Surg. 2007;193(1):111-3.

Igwe PO, Ibrahim NA. Strangulated sliding spigelian hernia: A case report. Int J Surg Case Rep. 2018;53:475-78.2006:191.

Downloads

Published

2020-11-27

Issue

Section

Case Reports