PDF(Pubmed)
Abstract：
UNASSIGNED: The first clinical presentation of a hernia developing along the Spigelian line had been reported by Klinkosch. The Belgian anatomist Adriaan van der Spieghel (Adrianus Spigelius) was the first to describe the semilunar line now known as the linea Spigeli in 1645. Spigelian hernias are rare and account for 1 % to 2 % of all abdominal wall hernias. Most of these hernia occurs in the lower abdomen where posterior sheath is deficient. The hernia ring is well defined defect in the transverse aponeurosis.
METHODS: A 60 year old female, presented with a palpable lump at the right lower quadrant of the abdomen since 7 month before her presentation.
UNASSIGNED: For the first time the swelling is small and painless then gradually increase in size and associated with dull aching pain. The swelling was reducible with a defect of size 4 × 4 cm palpable in right iliac fossa. There was a positive cough impulse. The swelling was non tender. Other hernial orifices were normal. No inguinal lymphadenopathy noted. Abdominal ultrasonography done revealed a defect in abdominal wall in right iliac fossa with reducible bowel content. Depending on basis of clinical and investigations, a diagnosis of Spigelian hernia was made. After preparation for surgery, exploration done. The defect measuring 4 cm in length was identified and anatomical repair was done with nylon- 0, by suturing medial border of internal oblique and transverse abdominus muscle to the lateral border of rectum abdominal wall followed by hernioplasty by mesh.
CONCLUSIONS: Spigelian hernias are rare multifactorial disorder leading to defect in the transversus abdominis muscle in anterior abdominal wall. Spigelian hernias carry a significant risk of incarceration and strangulation of sac content. The management of spigelian hernias is almost always surgical which can be done in a traditional open fashion or laparoscopically.
METHODS: A 60 year old female, presented with a palpable lump at the right lower quadrant of the abdomen since 7 month before her presentation.
UNASSIGNED: For the first time the swelling is small and painless then gradually increase in size and associated with dull aching pain. The swelling was reducible with a defect of size 4 × 4 cm palpable in right iliac fossa. There was a positive cough impulse. The swelling was non tender. Other hernial orifices were normal. No inguinal lymphadenopathy noted. Abdominal ultrasonography done revealed a defect in abdominal wall in right iliac fossa with reducible bowel content. Depending on basis of clinical and investigations, a diagnosis of Spigelian hernia was made. After preparation for surgery, exploration done. The defect measuring 4 cm in length was identified and anatomical repair was done with nylon- 0, by suturing medial border of internal oblique and transverse abdominus muscle to the lateral border of rectum abdominal wall followed by hernioplasty by mesh.
CONCLUSIONS: Spigelian hernias are rare multifactorial disorder leading to defect in the transversus abdominis muscle in anterior abdominal wall. Spigelian hernias carry a significant risk of incarceration and strangulation of sac content. The management of spigelian hernias is almost always surgical which can be done in a traditional open fashion or laparoscopically.
摘要：
■Klinkosch报道了沿Spigelian线发展的疝气的首次临床表现。比利时解剖学家AdriaanvanderSpieghel（AdrianusSpigelius）是第一个在1645年描述现在被称为lineaSpigeli的半月线的人。Spigelian疝很少见，占所有腹壁疝的1％至2％。这些疝大多数发生在后鞘不足的下腹部。疝环是横腱膜中明确定义的缺陷。
方法：一位60岁的女性，自出现前7个月以来，腹部右下象限出现明显的肿块。
■第一次肿胀小且无痛，然后逐渐增大，并伴有隐痛。肿胀可减轻，右髂窝可见4×4厘米大小的缺损。有积极的咳嗽冲动。肿胀不嫩。其他疝孔均正常。未发现腹股沟淋巴结肿大。腹部超声检查显示右髂窝腹壁缺损，肠内容物减少。根据临床和调查，诊断为Spigelian疝.在准备手术后,探索完成。确定了长度为4cm的缺损，并通过将腹内斜肌和腹横肌的内侧边界缝合到直肠腹壁的外侧边界，然后通过网片进行疝修补术，用尼龙-0进行解剖修复。
结论：Spigelian疝是罕见的多因素疾病，可导致前腹壁腹横肌缺损。Spigelian疝具有严重的囊内容物嵌顿和绞窄的风险。斯皮氏疝的治疗几乎总是外科手术，可以传统的开放方式或腹腔镜方式进行。
方法：一位60岁的女性，自出现前7个月以来，腹部右下象限出现明显的肿块。
■第一次肿胀小且无痛，然后逐渐增大，并伴有隐痛。肿胀可减轻，右髂窝可见4×4厘米大小的缺损。有积极的咳嗽冲动。肿胀不嫩。其他疝孔均正常。未发现腹股沟淋巴结肿大。腹部超声检查显示右髂窝腹壁缺损，肠内容物减少。根据临床和调查，诊断为Spigelian疝.在准备手术后,探索完成。确定了长度为4cm的缺损，并通过将腹内斜肌和腹横肌的内侧边界缝合到直肠腹壁的外侧边界，然后通过网片进行疝修补术，用尼龙-0进行解剖修复。
结论：Spigelian疝是罕见的多因素疾病，可导致前腹壁腹横肌缺损。Spigelian疝具有严重的囊内容物嵌顿和绞窄的风险。斯皮氏疝的治疗几乎总是外科手术，可以传统的开放方式或腹腔镜方式进行。
