title: Concurrent Spigelian hernia and falciform ligament hernia in a 67-year-old female.
abstract: BACKGROUND
  Internal abdominal hernias account for 1% of all hernias but 5.8% of all bowel obstructions and hence are of significant clinical importance. Similarly Spigelian hernias account for only 0.12-2% of all abdominal wall hernias.
  
  
  METHODS
  We present and discuss the management of a case that presented with concurrent falciform ligament internal abdominal hernia and Spigelian hernia. We believe this is the first reported case of such an occurrence in the literature.
  
  
  CONCLUSIONS
  Due to the advancements in computer topography (CT) imaging many internal and Spigelian hernias are diagnosed pre-operatively though these scan are not always available or indicated in cases of suspected small bowel obstruction. Due to the high mortality rate of undiagnosed internal hernias a high clinical suspicion must be maintained. The authors recommend laparoscopic trans-abdominal repair of Spigelian hernias in order to examine the abdominal contents and exclude rare, though potentially serious internal hernias.
authors.affiliation: Department of Surgery, Cairns Base Hospital, 165-171 Esplanade, Cairns 4870 Queensland, Australia. Electronic address: az.griffin@gmail.com.
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Griffin
authors.affiliation: Griffith University, Gold Coast Department of Surgery, Gold Coast University Hospital, Australia.
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Schaefer
authors.affiliation: Griffith University, Gold Coast Department of Surgery, Gold Coast University Hospital, Australia.
authors.forename: Eshwarshanker
authors.initials: E
authors.lastname: Jeyarajan
authors.affiliation: James Cook University, Cairns Base Hospital, Australia.
authors.forename: Trent
authors.initials: T
authors.lastname: Cross
keywords: Abdominal wall; Falciform ligament; Hernia; Internal hernia; Spigelian