title: Richter-type Spigelian hernia: A case report and review of the literature.
abstract: BACKGROUND
  Abdominal wall hernias through the arcuate line termed Spigelian hernias are uncommon. These hernias presenting as a Richter-type, with strangulation of part of the circumference of the bowel wall is very rare.
  
  
  METHODS
  We report a 27-year-old male patient who presented with a Richter-type Spigelian hernia.
  
  
  METHODS
  A MEDLINE literature search of this rare entity yielded six publications presenting Richter-type Spigelian hernias. All of these articles and accompanying references were thoroughly reviewed. There was no gender or anatomical side predominance among the patients. All except our patient presented here were elderly. Pain was the most common symptom and was present in all patients. All patients underwent surgical repair and none reported recurrence of their hernia afterwards.
  
  
  CONCLUSIONS
  Richter-type Spigelian hernia is rare and has been reported infrequently in the existing literature. Clinical diagnosis is challenging and CT scan is the diagnostic study of choice. Surgical repair is the definitive treatment and involves primary or mesh repair of the defect as appropriate. Necrotic bowel should be resected and we recommend biologic mesh repair in these cases if the defect is large.
authors.affiliation: Department of Surgery, Drexel University College of Medicine, 245 N. 15th Street, Rm. 7150, Philadelphia, PA 19102, United States. Electronic address: dsfoster@gmail.com.
authors.forename: Deshka
authors.initials: D
authors.lastname: Foster
authors.affiliation: Department of Surgery, Drexel University College of Medicine, 245 N. 15th Street, Rm. 7150, Philadelphia, PA 19102, United States. Electronic address: doctorsudhan@gmail.com.
authors.forename: Sudhan
authors.initials: S
authors.lastname: Nagarajan
authors.affiliation: Department of Surgery, Drexel University College of Medicine, 245 N. 15th Street, Rm. 7150, Philadelphia, PA 19102, United States. Electronic address: lucian.panait@drexelmed.edu.
authors.forename: Lucian
authors.initials: L
authors.lastname: Panait
keywords: Richter-type hernia; Spigelian hernia