Spigelian hernia is a rare type of abdominal hernia that occurs along the edge of the rectus abdominis muscle, which runs vertically along the midline of the abdomen. This hernia protrudes through the spigelian fascia, which is a thin layer of tissue located between the lateral border of the rectus muscle and the semilunar line of the abdomen. The hernia typically occurs in the lower abdomen, below the umbilicus.
Symptoms
- Pain or discomfort in the lower abdomen
- A small lump or bulge in the abdominal wall
- Nausea or vomiting
- Constipation or difficulty passing gas
- Sharp pain during activities that increase intra-abdominal pressure (such as coughing or lifting heavy objects)
Causes
- Weakness in the abdominal muscles due to aging, obesity, pregnancy, or previous surgery
- Chronic coughing or straining during bowel movements
- Trauma to the abdominal wall
- Genetics
Risk factors
- Age (middle-aged or older)
- Obesity
- Pregnancy
- Chronic coughing or straining during bowel movements
- Previous abdominal surgery
- Connective tissue disorders
- Associated conditions:
- Other types of hernias, such as inguinal or umbilical hernias
- Adhesions (scar tissue that forms after surgery or inflammation)
- Intestinal obstruction
Diagnosis
- Physical examination, including palpation of the abdomen to detect a lump or bulge
- Imaging tests, such as ultrasound or CT scan, to confirm the diagnosis and determine the size and location of the hernia
Differential diagnosis
- Other types of abdominal wall hernias, such as inguinal or umbilical hernias
- Appendicitis
- Diverticulitis
- Ovarian cysts or tumors
Treatment options
- Surgery to repair the hernia, either through an open incision or laparoscopically
- Observation and monitoring of the hernia if it is small and not causing symptoms
- Pain management with medications such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs)
Typical recovery timeframes
Recovery time after surgery varies depending on the size and location of the hernia and the surgical technique used. Most patients are able to resume normal activities within several weeks after surgery.
Prognosis
The prognosis for spigelian hernia is generally good with prompt diagnosis and treatment. If left untreated, complications such as intestinal obstruction or strangulation of the hernia contents can occur, which can be life-threatening.