A Spigelian is the type of ventral hernia where aponeurotic fascia pushes through a hole in the junction of the linea semilunaris and the arcuate line creating a bulge. It appears in the abdomen lower quadrant between an area of dense fibrous tissue and abdominal wall muscles causing a (Spigelian aponeurosis).It is the protuberance, of omentum, adipose tissue, or bowel in that weak space between the abdominal wall muscles, that ultimately pushes the intestines or superficial fatty tissue through a hole causing a defect. As a result, it creates the movement of an organ or a loop of intestine in the weakened body space that it is not supposed to be in. It is at this separation (aponeurosis) in the ventral abdominal region, that herniation most commonly occurs. Spigelian hernias are rare compared to other types of hernias because they do not develop under abdominal layers of fat but between fascia tissue that connects to muscle. The Spigelian hernia is generally smaller in diameter, typically measuring 1–2 cm., and the risk of tissue becoming strangulated is high. Signs and symptoms
Individuals typically present with either intermittent pain (coming and going), a lump, or mass all which are classic signs of a bowel obstruction. The patient may have a protuberance when standing in an upright position although discomfort can sometimes be confused by its anatomical region for a peptic ulceration. The bulge may be painful when the patient stretches but then goes away when they are lying down in a resting position.
Mesh-free laparoscopic suture repair is an uncomplicated approach to small Spigelian hernias combined with the benefits of a closure without the anguish and cost associated with foreign material. Eponym
Adriaan van den Spiegel, born in Brussels, was an anatomist at the University of Padua during the 17th century. In 1619 he became a professor of surgery. Spiegel was the first to described this rare hernia in 1627. The history of the Spigelian hernia became acknowledged in 1645, twenty years after Spiegels death. In 1764, almost a century later, the Flemish anatomist, Josef Klinkosch was acknowledged for recognizing and describing a hernia located in the Spigelian fascia, and coined the term Spigelian hernia. Raveenthiran syndrome
Raveenthiran described a new syndrome in which Spigelian hernia and cryptorchidism (undescended testis) occur together. Some common complications of this distinct syndrome cryptorchidism are testicular torsion, and its link to testicular cancer. References
External links
Adriaan van den Spiegel at Who Named It? Laparoscopic Repair of Spigelian Hernia Medtube