[Diagnosis and treatment of Spigelian hernia].
BACKGROUND
Spigelian hernia is a rare condition, which is frequently difficult to diagnose. This study describes our experience and we briefly discuss our findings in relation to the sparse literature.


METHODS
Seven-year retrospective study (2000-2006) with prospective follow-up in a consecutive series of patients.


RESULTS
We identified a total of 12 patients with 13 spigelian hernias among 379 patients with ventral hernia (3.1%). Symptoms and clinical findings varied substantially between patients. Due to strangulation, four patients underwent acute operation and eight patients underwent elective operation (laparoscopic (n = 7); open (n = 1)). One patient was treated conservatively. After a median of 3.3 years (range 0.8 to 6.8 years) recurrence was found in one patient and one patient (without recurrence) had moderate pain at the former hernia site.


CONCLUSIONS
Due to the relatively high risk of strangulation, all patients with spigelian hernias should be offered surgery regardless of symptoms. Pain and perhaps bulging at the semilunar line indicates a spigelian hernia, but the diagnosis can be difficult to establish. When in doubt, we suggest the use of computed tomography and, subsequently, diagnostic laparoscopy and laparoscopic repair.
Louring-Andersen
Martin
M
Kirurgisk Afdeling, Køge Sygehus, DK-4600 Køge, Denmark. louringandersen@gmail.com
Hjørne
Flemming Pii
FP
Skovdal
Jan
J
Bisgaard
Thue
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed