Shahbaz Khan Panhwer, Erum Kazim, Saeed Quraishy.
Spigelian Hernia: A Rare Variety of Ventral Hernia.
Natl J Health Sci Jan ;2(1):39-42.

Spigelian hernia is rare and generally difficult to diagnose because of its location and vague non-specific symptoms. A Spigelian hernia occurs through the Spigelian fascia, which is composed of the aponeurotic layer between rectus muscle medially and semilunar line laterally. Nearly all Spigelian hernias occur at or below the arcuate line. The absence of posterior rectus fascia may contribute to an inherent weakness in this area. These are often interparietal, with the hernia sac dissecting posterior to the external oblique aponeurosis. Patient often present with localized pain in the area without a bulge because the hernia lies beneath the intact external oblique aponeurosis and they are easily overlooked by obesity. Ultrasound or CT scan of the abdomen can be useful to establish the diagnosis. Spigelian hernias should always be surgically repaired in view of the high frequency of incarceration. We report a 40 year old lady who presented to us with complaint of pain in her right Epigastric & lumbar region along with vague swelling on standing. Diagnosis of Spigelian hernia was made on the basis of ultrasound & CT scan findings & it was confirmed on exploration. The hernia was reduced & licheneistein mesh repair was performed, her recovery was uneventful.

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