title: Herniography (peritoneography) for diagnosis of Spigelian hernia.
abstract: BACKGROUND
  Spigelian hernia is a rare clinical condition. It is difficult to diagnose in absence of obvious clinical signs. Ultrasound scan, cross-sectional imaging and contrast studies like herniography have been widely used for detecting occult abdominal wall hernias in symptomatic patients.
  
  
  OBJECTIVE
  We present our experience of detecting a clinically occult Spigelian hernia in a 56-year-old symptomatic male patient, who had concomitant left sided inguinal and Spigelian hernias. In this patient, the Spigelian hernia was not detected on ultrasound scan. We also present a review of literature on the role of herniography in the diagnosis of this rare condition.
  
  
  CONCLUSIONS
  Herniography is a sensitive investigation for evaluation of occult hernias. However, it is an invasive contrast study and therefore must be used selectively. Non-invasive real-time imaging like ultrasonography remains the first line of investigation for detecting occult hernias.
authors.affiliation: Department of Surgery, South Tyneside District Hospital, South Shields.
authors.forename: G
authors.initials: G
authors.lastname: Sen
authors.forename: R
authors.initials: R
authors.lastname: Lochan
authors.forename: B V
authors.initials: BV
authors.lastname: Joypaul
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D006555:Hernia, Ventral / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011859:Radiography; D018570:Risk Assessment; D016896:Treatment Outcome