What is a spigelian hernia?

A spigelian hernia forms through the spigelian aponeurosis. This is a layer of abdominal muscles that rests between the lateral edge of the rectus muscle and the linea semilunaris.

An untreated Spigelian hernia can cause complications. This makes it important to receive prompt medical treatment.

Symptoms of a Spigelian hernia

Symptoms of a Spigelian hernia vary from person to person and range from mild to severe. A common sign of this hernia is a lump or bulge either below or to the side of the belly button. The lump may feel soft to the touch.

Another symptom is constant or intermittent abdominal pain. Pain intensity can vary. Some people have increased discomfort during certain activities, such as:

  • exercise
  • heavy lifting
  • bowel movements

A Spigelian hernia can also decrease bowel function.

Causes and risk factors of a Spigelian hernia

Similar to other types of hernias, Spigelian hernias are caused by weaknesses in the muscles of the abdominal wall. This allows protruding of organs and tissue. There isn’t just one specific cause for this weakness. Different factors can contribute to a hernia.

Some people develop abdominal weakening after experiencing an injury, such as trauma from lifting a heavy object. In other cases, the hernia is caused by conditions that trigger chronic coughing, such as the common cold, bronchitis, or allergies.

Excess fluid in the abdomen can also cause weakness in the abdominal walls, called ascites.

Spigelian hernias are rare, but they can happen to anyone. Some people, however, have a higher risk. These types of hernias are more common in men over the age of 50. Other risk factors for a Spigelian hernia include pregnancy and being overweight.

Diagnosis of a Spigelian hernia

See a doctor if you suspect a hernia. If you don’t have pain or discomfort, it’s possible to live with the hernia. But any hernia that causes pain needs medical attention. A spigelian hernia will not resolve without treatment.

Doctors can typically diagnose an ordinary hernia upon completion of a physical examination. Spigelian hernias are more challenging to diagnose. This is because they don’t have the same physical characteristics of ordinary hernias. Because a spigelian hernia develops within the muscle wall, a bulge or lump isn’t always visible.

Your doctor may ask about the location of pain, and then order an imaging test to view the inside of your body. This includes:

  • an X-ray
  • an ultrasound, which uses sound waves to create pictures
  • a CT scan, which creates detailed cross-sectional pictures

These tools allow close examination of areas of concern to determine the presence of a hernia.

Complications of a spigelian hernia

Don’t ignore symptoms of a spigelian hernia. If left untreated, these hernias can cause significant damage and life-threatening complications.

Hernias can also increase in size. This can cut off blood supply to your major organs or cause a bowel blockage. This complication is called strangulation.

Symptoms of strangulation include:

  • vomiting
  • nausea
  • severe abdominal pain

People who experience strangulation need emergency surgery.

Even if a spigelian hernia doesn’t become enlarged or cause pain, your doctor may recommend repair.

Treatment for a spigelian hernia

Hernia repair surgery is the only way to treat a spigelian hernia. The decision to have surgery is based on the size of the hernia and whether you experience pain. If you choose surgery, a surgeon can perform an open mesh repair by making an incision in your abdomen near the hernia. The surgeon moves bulging tissue and organs back to the proper location, and then repairs the hole in your stomach wall.

You may also choose to correct the hernia by using a minimally invasive procedure called laparoscopic hernia repair. A surgeon makes a smaller incision in your abdomen and repairs the hernia using a thin surgical instrument with a camera attached to the end.

Risks and recovery

Both types of surgery can be completed on an outpatient basis, or you may have to stay one night in the hospital. Recovery can take between three to six weeks with open mesh repair, and one to two weeks with laparoscopic hernia repair. You should avoid strenuous activity during recovery.

Risks associated with surgery include bleeding or bruising underneath the skin and infections. See a doctor if you experience increased pain, persistent bleeding, a fever, or vomiting after hernia repair surgery.

What is the outlook for a spigelian hernia?

A spigelian hernia can cause pain and grow in size. But the outlook is positive with early medical intervention and surgery to correct the hole in your abdominal muscles. Surgery is the only way to repair the problem and avoid serious, life-threatening complications.