Spigelian hernia is:
A. Intraparietal internal hernia
B. Hernia occurring at the level of arcuate line
C. Hernia through the lineaalba above or below the umbilicus.
D. Posterior abdominal wall hernia
A. Intraparietal internal hernia
B. Hernia occurring at the level of arcuate line
C. Hernia through the lineaalba above or below the umbilicus.
D. Posterior abdominal wall hernia
Ans.
B. Hernia occurring at the level of arcuate line.
Spigelian hernia:
•This is a variety of interparietal
hernia occurring at the level of the arcuate line.
•It is very rare with only 1000 cases
reponed in the literature.
•The fundus of the sac, clothed by
exrtaperitoneal fat, may lie beneath the internal oblique muscle where it is
virtually impalpable.
•More often it advances through that
muscle and spreads out like a mushroom between the internal and external
oblique muscles, and gives rise to a more evident swelling.
•The patient is often corpulent and
usually over 50 years of age, men and women being equally affected. Typically,
a soft, reducible mass will be encountered lateral to the rectus muscle and
below the umbilicus.
•Diagnosis is confirmed by CT or USG.
the latter having the advantage of being able to stand the patient upright ifno
defect is visible in the reclining position.
•Owing to the rigid fascia surrounding
the neck, strangulation may occur.
•Treatment.
o Operation. If a defect is palpable.a
muscle-splitting approach is used.
o, Ext oblique, Int oblique, Transverse
abd retracted laterally during surgery.
