Spigelian Hernia
More likely to affect older men, a spigelian hernia is different from other common types of hernias in that it develops muscles and the connecting tissues that link muscles together and not within layers of fat.
It’s a rare type of hernia that does not usually produce noticeable swelling or “bulging” like what’s seen with a more common inguinal (inner groin) hernia. If not treated, a spigelian hernia may contribute to a bowel blockage or block the flow of blood from other tissues and organs.
Spigelian Hernia Symptoms
Some type of abdominal discomfort is usually the first sign or symptom associated with a spigelian hernia. Abnormal swelling isn’t usually clearly discernible, although thinner people with visible abdominal muscles may notice swelling in the form of a bump around the naval (belly button). Other symptoms and signs associated with a spigelian hernia include:
- Periodic abdominal pain that comes and goes
- Issues with bowel functions
- Tenderness in the affected area
- Pain that becomes worse when straining the abdominal area
Signs of a Blockage
It’s important to seek immediate medical assistance if there are signs that a spigelian hernia may have caused a bowel blockage or obstructed blood flow to nearby organs and tissues. Sudden and intense abdominal pain, nausea and vomiting not related to anything food-related or a virus, and not being to make a bowel movement for several days are among the signs that could suggest that a blockage has occurred.
Causes and Risk Factors
A spigelian hernia develops in an area where there are weakened abdominal muscles. Tissues or organs then protrude through what’s termed the spigelian fascia. Risk factors associated with this type of hernia include being overweight, having COPD or similar conditions that result in chronic coughing, experiencing abdominal trauma, pregnancy, and frequent bowel straining.
Diagnosing a Spigelian Hernia
Because it’s usually difficult to confirm the existence of a spigelian hernia from a physical examination alone, image testing is typically necessary to make a positive diagnosis. This usually involves an abdominal ultrasound or CT scan. A spigelian hernia is also sometimes detected when abdominal or pelvic surgery is performed for another reason, during exploratory surgery, or when a colonoscopy is performed as part of a routine colon cancer screening.
Surgery
The only way to treat a spigelian hernia is with surgery. It’s becoming increasingly common for hernias to be repaired with minimally invasive laparoscopic techniques, which means smaller incisions and the use of a lighted scope and specialized instruments. A mesh patch is used to repair the weakened part of the abdominal wall. With open repair, a larger incision in the stomach is made.
Recovery from laparoscopic spigelian hernia repair usually takes a few weeks for patients who are good candidates for a less invasive form of hernia surgery. It’s not necessarily a preventable type of hernia since some individuals are born with muscle tissue that’s abnormally thin in some areas. Also, people who have had surgery for one type of hernia tend to be susceptible to developing another type of hernia at some point. What can be done, however, is to be mindful of proper lifting techniques and avoid excessive lower abdominal/pelvic straining as much as possible.