Spigelian hernia
Spigelian Hernia Repair and Treatment
Specialist assessment of this uncommon abdominal wall hernia, including imaging and surgical repair where appropriate.
Overview
Understanding spigelian hernias
A Spigelian hernia is a rare abdominal wall hernia that occurs through the Spigelian fascia, usually at the side of the rectus abdominis muscle. Because it may be small, deep or difficult to feel, imaging is sometimes needed to confirm the diagnosis.
When to seek urgent help
A painful irreducible lump, increasing tenderness, vomiting, fever or abdominal swelling should be treated as urgent.
What is a Spigelian hernia?
A Spigelian hernia occurs along the lateral abdominal wall, often around the level between the umbilicus and hip bone. It may contain fat or bowel and can present as a lump or localised pain.
Who commonly presents with it?
Spigelian hernias are rare and tend to occur later in life. They are more common in people who are overweight and can also occur after pregnancy or with increased abdominal pressure.
Spigelian hernia symptoms
Symptoms can include a lump or tender area on the side of the abdomen, pain on coughing, discomfort when straining and occasionally a painful non-reducible lump. Some patients have pain without a clear visible swelling.
Why prompt assessment matters
Spigelian hernias have a recognised risk of incarceration or strangulation because the defect can be narrow.
Diagnosis
Diagnosis may be made by examination, but ultrasound or CT scan is often useful when the hernia is not obvious or symptoms are difficult to localise.
Spigelian hernia repair
Most patients are advised to consider surgical repair. The operation can be performed by open surgery through an incision over the hernia or by keyhole surgery in selected patients.
Mesh repair
Mesh may be used if the defect is larger or reinforcement is needed. The decision depends on the size and position of the hernia and the operation performed.
Recovery
Most patients go home the same day or after one night. Gentle mobilisation is encouraged, with a gradual return to full activities.
Frequently asked questions
Spigelian hernia FAQs
Why can a Spigelian hernia be difficult to diagnose?
Spigelian hernias can sit between layers of the abdominal wall, so the lump may be subtle or intermittent. Ultrasound or CT may be needed if the diagnosis is unclear.
Is surgery usually recommended for a Spigelian hernia?
Yes. Because Spigelian hernias have a recognised risk of becoming trapped or strangulated, surgical repair is commonly recommended.
Can a Spigelian hernia be repaired by keyhole surgery?
In selected patients, laparoscopic repair may be suitable, particularly where the hernia is difficult to locate.
What symptoms suggest a trapped Spigelian hernia?
A painful lump that does not reduce, increasing tenderness, vomiting, fever or abdominal swelling should be treated as urgent.
How is a Spigelian hernia diagnosed?
Diagnosis may be made by examination, but ultrasound or CT may be needed when the lump is difficult to feel or the diagnosis is uncertain.
Specialist care in Manchester
Book a consultation with Mr Christian Macutkiewicz
Arrange a private consultation at Spire Manchester Hospital to discuss your symptoms, diagnosis and treatment options.
Hernia Clinic Manchester 