Spigelian hernia: Difference between revisions
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==Overview== | ==Overview== | ||
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Most of these hernias are small, and, as such, there is a high risk of strangulation. Most of them develop around age 50 (4th-7th decade of life). As an entity, they are rare,<ref name=larson>{{cite journal |author=Larson DW, Farley DR |title=Spigelian hernias: repair and outcome for 81 patients |journal=World journal of surgery |volume=26 |issue=10 |pages=1277-81 |year=2002 |pmid=12205553 |doi=10.1007/s00268-002-6605-0}}</ref> when compared other types of hernias. | Most of these hernias are small, and, as such, there is a high risk of strangulation. Most of them develop around age 50 (4th-7th decade of life). As an entity, they are rare,<ref name=larson>{{cite journal |author=Larson DW, Farley DR |title=Spigelian hernias: repair and outcome for 81 patients |journal=World journal of surgery |volume=26 |issue=10 |pages=1277-81 |year=2002 |pmid=12205553 |doi=10.1007/s00268-002-6605-0}}</ref> when compared other types of hernias. | ||
==Historical Perspective== | |||
[[Adriaan van den Spiegel]], a [[surgeon]]-[[anatomist]] born in Brussels, described this hernia in 1645. | |||
==Classification== | |||
==Pathophysiology== | |||
==Causes== | |||
==Differentiating {{PAGENAME}} from Other Diseases== | |||
==Epidemiology and Demographics== | |||
==Risk Factors== | |||
==Screening== | |||
==Natural History, Complications, and Prognosis== | |||
===Natural History=== | |||
===Complications=== | |||
===Prognosis=== | |||
==Diagnosis== | ==Diagnosis== | ||
===Diagnostic Criteria=== | |||
===History and Symptoms=== | |||
===Physical Examination=== | |||
Patients typically present with either an intermittent mass, localized pain, or signs of [[bowel obstruction]].<ref name=larson/> [[Ultrasonography]] or a [[CT scan]] can establish the diagnosis. | Patients typically present with either an intermittent mass, localized pain, or signs of [[bowel obstruction]].<ref name=larson/> [[Ultrasonography]] or a [[CT scan]] can establish the diagnosis. | ||
===Laboratory Findings=== | |||
===Imaging Findings=== | |||
====CT==== | |||
'''CT demonstrates small bowel obstruction secondary to a right spigelian hernia''' | '''CT demonstrates small bowel obstruction secondary to a right spigelian hernia''' | ||
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</gallery> | </gallery> | ||
===Other Diagnostic Studies=== | |||
==Treatment== | ==Treatment== | ||
===Medical Therapy=== | |||
These hernias should be repaired because of the high risk of strangulation;<ref>{{cite journal |author=Vos DI, Scheltinga MR |title=Incidence and outcome of surgical repair of spigelian hernia |journal=The British journal of surgery |volume=91 |issue=5 |pages=640-4 |year=2004 |pmid=15122618 |doi=10.1002/bjs.4524}}</ref> fortunately, surgery is straight-forward, with only larger defects requiring a [[mesh]] [[prosthesis]]. | These hernias should be repaired because of the high risk of strangulation;<ref>{{cite journal |author=Vos DI, Scheltinga MR |title=Incidence and outcome of surgical repair of spigelian hernia |journal=The British journal of surgery |volume=91 |issue=5 |pages=640-4 |year=2004 |pmid=15122618 |doi=10.1002/bjs.4524}}</ref> fortunately, surgery is straight-forward, with only larger defects requiring a [[mesh]] [[prosthesis]]. | ||
== | ===Surgery=== | ||
== | ===Prevention=== | ||
==External links== | ==External links== | ||
* http://www.whonamedit.com/doctor.cfm/2280.html | * http://www.whonamedit.com/doctor.cfm/2280.html | ||
{{ | ==References== | ||
{{reflist|2}} | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[pl:Przepuklina Spiegela]] | [[pl:Przepuklina Spiegela]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 20:27, 11 July 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
A Spigelian hernia (or lateral ventral hernia) is a hernia through the spigelian fascia, which is the aponeurotic layer between the rectus abdominis muscle medially, and the semilunar line laterally. These hernias almost always develop at or below the linea arcuata, probably because of the lack of posterior rectus sheath. These are generally interparietal hernias, meaning that they do not lie below the subcutaneous fat but penetrate between the muscles of the abdominal wall; therefore, there is often no notable swelling.
Most of these hernias are small, and, as such, there is a high risk of strangulation. Most of them develop around age 50 (4th-7th decade of life). As an entity, they are rare,[1] when compared other types of hernias.
Historical Perspective
Adriaan van den Spiegel, a surgeon-anatomist born in Brussels, described this hernia in 1645.
Classification
Pathophysiology
Causes
Differentiating Spigelian hernia from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Patients typically present with either an intermittent mass, localized pain, or signs of bowel obstruction.[1] Ultrasonography or a CT scan can establish the diagnosis.
Laboratory Findings
Imaging Findings
CT
CT demonstrates small bowel obstruction secondary to a right spigelian hernia
Other Diagnostic Studies
Treatment
Medical Therapy
These hernias should be repaired because of the high risk of strangulation;[2] fortunately, surgery is straight-forward, with only larger defects requiring a mesh prosthesis.
Surgery
Prevention
External links
References
- ↑ 1.0 1.1 Larson DW, Farley DR (2002). "Spigelian hernias: repair and outcome for 81 patients". World journal of surgery. 26 (10): 1277–81. doi:10.1007/s00268-002-6605-0. PMID 12205553.
- ↑ Vos DI, Scheltinga MR (2004). "Incidence and outcome of surgical repair of spigelian hernia". The British journal of surgery. 91 (5): 640–4. doi:10.1002/bjs.4524. PMID 15122618.