The history of the spigelian hernia became acknowledged in. A tension free surgical technique, a sublaymesh, are options to have. Indirect inguinal hernia an indirect inguinal hernia occurs when any intraabdominal structure protrudes through the deep inguinal ring entering the inguinal canal. Rbcp spiegelian hernia secondary to abdominoplasty. Sin embargo, su verdadera incidencia podria ser mayor. The present report concerns four patients for whom the diagnosis of spontaneous lateral ventral hernia appearing above the inferior. Scribd is the worlds largest social reading and publishing site.
The omental vessels can be traced beyond the confines of the peritoneum. Abdominal wall hernias are a common imaging finding in the abdomen and may be complicated by strangulation, incarceration, or trauma. The use of the laparoscope has simplified the diagnosis and. O tratamento da hernia spigeliana deve ser cirurgico9. The omentum is seen to herniate through a defect in the transversus abdominis and the internal oblique muscles on the left side. Meshfree laparoscopic repair of small spigelian hernias. A spigelian hernia is a hernia through the spigelian fascia or layer of tissue that separates two groups of abdominal muscles.
All structured data from the file and property namespaces is available under the creative commons cc0 license. Critical to the repair of richters hernia is an adequate evaluation of the intestine for viability. Spigelian hernias are rare and account for 1% to 2% of all abdominal wall hernias. The processus vaginalis must be patent for this type of hernia to occur. The use of the laparoscope has simplified the diagnosis and subsequent repair of these rare hernias. Spigelian fascia is a layer between the rectus abdominis muscle and the semilunar line laterally.
Antibiotics are given during the operation to minimise the risk of deepseated infection. In this case, the hernia occurred in the anterolateral abdominal wall with herniation of the distal ileum and mesentery, in addition to a large right inguinal hernia. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias, internal hernias, the abdominal wall anterior and posterolateral aspects, the diaphragm and the perineum, the advancement of abdominal wall and hernia surgery in all aspects, the study of anatomical, physiological, pathological and therapeutic. Hernias pared abdominal 2017 hernia inguinalhernia femoral. The spigelian hernia is poorly known in gynaecology. Spigelian hernia in children, two cases of unusual etiology.
The clinical presentation varies, depending on the contents of the hernial sac and the degree and type of herniation. The antimesenteric border of the intestine must protrude into the hernia sac the most common location is at the site of a femoral hernia. Sep 03, 2008 spigelian hernia has been described as a complication of chronic ambulatory peritoneal dialysis capd. The pathogenesis of these rare hernias is discussed. Spigelian hernia repair you will be asked to attend the preadmission assessment clinic prior to admission to ensure you are fit for surgery, allowing time for the necessary preoperative tests, which may include blood tests, cardiogram ecg and a chest xray.
Because of the risk of developing complications, most abdominal wall hernias are surgically repaired, even if asymptomatic. Symptoms vary from insidious to localised pain, an intermittent mass andor a bowel obstruction. A free powerpoint ppt presentation displayed as a flash slide show on id. A 5yearold girl with blunt trauma to the abdomen and a 3monthold boy after abdominal surgery were found to have a spigelian hernia. Spigelian hernia is in itself very rare and more over it is difficult to diagnose clinically.
The hernial ring is a welldefined defect in the aponeurosis. Abstract spigelian hernia is a rare disease in children. Epidemiology they are rare and account for 1% range 0. Spiegels hernia can cause serious cases of organ incarceration because its diagnosis is often made at a late stage. Pdf the spieghelian hernia or ventrolateral hernia is produced through the effect of rupture of the abdominal wall fibers, near the semi lunar. Findings to facilitate diagnosis are palpable hernia and a palpable hernial orifice. An indirect inguinal hernia is a congenital lesion. River2 collected 112 cases from the worlds literature and added four cases of his own to bring the total number to 116.
A hernia through the fascia along the lateral edge of the rectus muscle at the space between the semilunar line and the lateral edge of the rectus muscle usually successfully repaired by approximation with interrupted sutures. Spigelian hernias are a rare defect of the abdominal wall located on the outer edge of the crescent line in the area that joins the fascia of the anterior rectus muscle to the sheaths of the wide muscles of the abdomen. Spigelian hernias may be causally related to secondary trocar insertion. Spigelian hernia symptoms, causes, location, treatment, pictures. Hernia, spiegels linea semilunaris plication, abdominoplasty resumo. The muscles are called the rectus muscles and the lateral obliques. The diagnosis of spigelian hernia presents greater difficulties than its treatment.
Klinklosch1 accurately located a hernia in this line. How lichtenstein hernia repair affects abdominal and anal resting pressures. Dec 11, 2014 richtertype spigelian hernias are extremely unusual, with very few reports in the literature. How lichtenstein hernia repair affects abdominal and anal.
Spigelian hernia sh is a surgical rarity in children, which occurs through slitlike defects in the anterior abdominal wall adjacent to the semilunar line, the convexity lateral line which joins the nine ribs to the pubic tubercle and signs the limit between the muscular and aponeurotic portion of transversus abdominis muscle. Laparoscopic technique in the management of spigelian hernia. A new hybrid minilaparoscopic technique for spigelian hernia. The lichtenstein tension free hernioplasty was first introduced in 1984 and evolved through 1988. Files are available under licenses specified on their description page. How to treat sciatica effective home exercise progression for sciatic nerve pain duration. Often known as a lateral ventral hernia, this type of hernia is a form of hernia developing throughout the. Spiegelian hernia, a rare defect of the abdominal wall, is characterized by protrusion of organs, peri.
The rarity of spigelian hernias, the frequent subtle clinical findings, and the relatively high incarceration rate justify a high suspicion for spigelian hernia in patients presenting with vague symptoms in the spigelian belt, in order not to delay diagnosis. Onuigbo wib, medical foundation and clinic, 8 nsukka lane, enugu 400001, nigeria, email. Spigelian hernia, also known as lateral ventral hernia, is a type of abdominal hernia along the semilunar line, resulting in herniation between the muscles of the abdominal wall. Our first case is the third recorded traumatic spigelian hernia occuring in a child, and the second is the first postoperative case described after abdominal repair of a bochdalek hernia. Ppt hernias powerpoint presentation free to view id. Some risk factors outlined above could be eliminated or at least lessened. Pdf the authors report the case of a fifty years old female who presented a left pain and showed a deep mass that can be felt in the left side of.
Abd wall hernias university of tennessee college of medicine. Europe pmc is an archive of life sciences journal literature. The repair was performed using a composite mesh prosthesis consisting of a sandwich of polyester fiber mesh and polyglactin 910 mesh, sutured together with polyglactin 910 suture at the operating table before introduction. At padua he studied anatomy under girolamo fabrici. Recurrence fortunately recurrence after hernia surgery should be rare. For much of his career he practiced medicine in padua, and is considered one of the great physicians associated with the city. The history of the spigelian hernia became acknowledged in 1645, twenty years after spiegel s death. The pain, which is the most common symptom, varies and there is no typical pain of spigelian hernia. The open mesh repair of spigelian hernia sciencedirect. The spigelian hernia has been repaired by both conventional and laparoscopic approach. Spigelian hernia pictures, symptoms, location, causes. A feasibility report of a novel and unpublished surgical approach for spiegels hernia. The repair was performed using a composite mesh prosthesis consisting of a sandwich of polyester fiber mesh and polyglactin 910 mesh, sutured together with polyglactin 910 suture at. Mobilisatie en oefenschema na een standaard herniaoperatie.
Repeated laparoscopic treatment of recurrent inguinal hernias. If you continue browsing the site, you agree to the use of cookies on this website. The spigelian aponeurosis is widest between 0 and 6 cm cranial to the interspinous plane and 8590% of the hernias occur within this spigelian hernia belt figure 3. Spiegel was the first to described this rare hernia in 1627. Round ligament cyst simulating incarcerated inguinal hernia. Jan 30, 2009 abstract spigelian hernias are uncommon, and preoperative diagnosis is often difficult. May 15, 2017 a spigelian hernia is a rare hernia through the spigelian fascia between the rectus muscle and the semilunar line. Endoscopic totally extraperitoneal inguinal hernia repair versus. Apr 10, 2009 a planned elective repair, via the laparoscope, of a spigelian hernia is described. Planned laparoscopic repair of a spigelian hernia using a. Repair of the spigelian hernia is advisable due to the 20% risk of strangulation. The spiegel hernia is rare and is difficult to diagnose clinically. An ebook reader can be a software application for use on a computer such as microsofts free reader application, or a booksized computer this is used solely as a reading device such as nuvomedias rocket ebook.