Incarcerated Spigelian Hernias: A Rare Cause of a High-grade Small Bowel Obstruction

Lavin, Arye; Gupta, Anupam; Lopez-Viego, Miguel A.; Buicko, Jessica L.

doi:10.7759/cureus.7397

Cited by 6 publications

(8 citation statements)

References 8 publications

(12 reference statements)

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“…The Spigelian hernia itself is an uncommon occurrence, while it is safe to say that an incarcerated SH is a true rarity. The hernia sac usually encompasses the omentum, a segment of the small intestine, or the appendix [6,7,8].…”

Section: Discussionmentioning

confidence: 99%

Intraperitoneal onlay mesh laparoscopic repair of an incarcerated Spigelian hernia - case report and literature review

Milosavljević

Crnokrak

Gluhovic³

et al. 2023

Srp Arh Celok Lek

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Introduction. Spigelian hernia is a type of lateral ventral hernia, localized between the rectus abdominis muscle and the semilunar line. Current literary data indicate that the prevalence of Spigelian hernia is 1-2% of all hernias of the abdominal wall. Patients are most commonly asymptomatic. Case outline. We present a 63-year-old male patient, who was admitted to our hospital as an emergency case due to lower abdominal pain. Upon hospital admission, radiological diagnostics, and a physical examination, the presence of a Spigelian hernia was verified, which, at the moment of the examination, was incarcerated. It was established that surgical treatment was indicated. We performed laparoscopic intraperitoneal onlay mesh plastic in the standard way. The patient was discharged from hospital on the following day with normal values of vital and laboratory parameters. Conclusion. The Spigelian hernia, although first described many years ago, remains a diagnostic challenge, which is why its occurrence requires a multidisciplinary approach for the purpose of establishing a timely and accurate diagnosis. Within the surgical treatment of this state, there are several surgical techniques, and special focus is placed on the minimally invasive surgical approach. Also, within the minimally invasive surgical approach, there are several operating techniques.

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Section: Discussionmentioning

confidence: 99%

Intraperitoneal onlay mesh laparoscopic repair of an incarcerated Spigelian hernia - case report and literature review

Milosavljević

Crnokrak

Gluhovic³

et al. 2023

Srp Arh Celok Lek

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“…Chronic onset shows no characteristic or pathognomonic signs or symptoms. Noncomplicated hernias can cause a vague abdominal discomfort or bowel dysfunction as the only appreciable symptoms in often incidental diagnosis [2] . Imaging procedures such as US and CT are nowadays routinely used and integrated to diagnose bowel emergencies, including herniations [9] .…”

Section: Discussionmentioning

confidence: 99%

“…However, CT is associated with a radiation exposure, which limits its role as a first line imaging modality for noncomplicated hernia [1] . Small bowel obstruction in incarcerated Spigelian hernia is a rare event [2] . We present a rare case of an incarcerated Spigelian hernia causing a closed loop small bowel obstruction in a 64-year-old man presenting with nausea, vomiting, and abdominal pain that was preoperatively diagnosed with ultrasound (US) and CT. At US and CT a closed loop obstruction in a Spigelian hernia was detected, resembling on both imaging modalities a “bulb-like“ appearance.…”

Section: Introductionmentioning

confidence: 99%

“Bulb-like” sign: Small bowel closed loop obstruction in incarcerated Spigelian hernia

Cesaro

Rocco²,

Rosano³

et al. 2021

Radiology Case Reports

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A Spigelian hernia is a rare hernia, making up approximately 0.1% of all abdominal wall hernias. This hernia goes through a defect in the Spigelian fascia which is the part of the transversus abdominis aponeurosis lateral to the rectus muscle, often at the level of the arcuate line, where the fascia is widest and weakest. Clinical diagnosis is difficult in patients without obvious abdominal mass but imaging can be a valuable adjunct in diagnosis. We report the case of a 64-year-old male who presented to our hospital with small bowel obstruction secondary to an incarcerated Spigelian hernia who was pre-operatively diagnosed with ultrasound and computed tomography. At ultrasound and computed tomography a closed loop obstruction in a Spigelian Hernia was detected, resembling on both imaging modalities a “bulb-like“ appearance.

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“…The diagnosis is therefore often first suspected when symptoms occur [4]. The defect of a Spigelian hernia is usually small and with sharp fascial margins, and risk of incarceration is described in the literature [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Outcomes After Spigelian Hernia Repair: A Nationwide Database Study

Lode

Jensen²,

Helgstrand³

et al. 2023

World j. surg.

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Background Spigelian hernia is a rare hernia of the abdominal wall. Due to lack of evidence, there is no standard recommendation for surgical technique of Spigelian hernia repair. The aim of this study was to evaluate the outcomes after open and laparoscopic, elective and emergency repair of Spigelian hernias on a nationwide basis. Methods Nationwide data from the Danish Ventral Hernia Database and the National Patient Registry was assessed to analyze outcomes after Spigelian hernia repair. A total of 365 patients were operated for Spigelian hernia in Denmark from 2007 to 2018. Ninety-day readmission, 90-day reoperation and long-term operation for recurrence were evaluated, as well as possible differences between open and laparoscopic, and elective and emergency repairs. Results Most of the patients (80.5%, 294/365) were operated by laparoscopic approach and 19.5% (71/365) were operated by open approach. Elective surgery was performed in 83.6% (305/365) of the patients and 16.4% (60/365) underwent emergency repair. There were no significant differences in 90-day readmission or reoperation rates between open or laparoscopic Spigelian hernia repairs, P = 0.778 and P = 0.531. Ninety-day readmission and 90-day reoperation rates were also comparable for elective versus emergency repair, P = 0.399 and P = 0.766. No difference was found in operation for recurrence rates between elective and emergency, nor open and laparoscopic Spigelian hernia repairs. Conclusions This study demonstrates that 16% of Spigelian hernia repairs are done in the emergency setting. Open and laparoscopic approach are comparable in terms of early readmission, reoperation, and recurrence rates.

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Incarcerated Spigelian Hernias: A Rare Cause of a High-grade Small Bowel Obstruction

Cited by 6 publications

References 8 publications

Intraperitoneal onlay mesh laparoscopic repair of an incarcerated Spigelian hernia - case report and literature review

Intraperitoneal onlay mesh laparoscopic repair of an incarcerated Spigelian hernia - case report and literature review

“Bulb-like” sign: Small bowel closed loop obstruction in incarcerated Spigelian hernia

Outcomes After Spigelian Hernia Repair: A Nationwide Database Study

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