Spigelian Hernia - Causes, Symptoms, Treatment & Repair
A Spigelian hernia is an abnormal protrusion of the contents of the abdominal cavity that usually results from an underlying pathology. It is the one that leads to increased intra-abdominal pressure and destruction of the abdominal aponeurotic layers and the abdominal wall. Spigelian hernia, although much less common than other hernia varieties, is still extremely unpleasant. To prevent the development of this unpleasant disease, it is important to know the symptoms that can indicate its occurrence.
What is a spigelian hernia?
Spigelian fascia is commonly referred to as a special layer of tissue that separates the two muscle groups in the front part of the abdomen. When a slit-shaped hole is formed in it - this is a Spigelian hernia. Such a disease most often affects the intestines, appendix, and the layer of fatty tissue that is located over the abdominal organs. Spiegel hernia can also appear on other organs. But it is much rarer than the inguinal or femoral varieties of this disease. They make up only 0.12-2% of the total number of hernias on the abdominal wall.
What causes a Spigelian hernia?
A Spigelian hernia can occur for a variety of reasons. The most common triggers include:
- abdominal trauma caused by a severe blow;
- frequent or prolonged constipation;
- chronic diseases that increase intra-abdominal pressure;
- weakness of the abdominal wall muscles as a consequence of natural aging or long-term illness.
Most often such a disease affects elderly people over 50 years of age. Therefore, when the first painful symptoms appear, it is recommended that they regularly undergo an ultrasound examination of a Spigelian hernia.
What are the symptoms of Spigelian hernia?
In some patients, the disease is asymptomatic. Others experience only minor soreness, and some patients suffer from pain regularly. The first symptom that usually appears from the occurrence of any hernia is abdominal pain. It may appear in a particular part of the entire abdominal area. Painful symptoms may also be felt when lifting something heavy, exercising, or during defecation. Abdominal pain may also occur with a severe cough.
Another obvious symptom of a Spigelian hernia is the appearance of a small bulge that usually appears near the navel. Just such a bump indicates a weakening of the abdominal wall. If you have painful sensations or a strange bulge in the abdominal area, the only sure way to determine the disease is to contact a qualified medical professional. He or she will be able to perform some procedures to accurately diagnose and select the right treatment. Depending on the location of the Spigelian hernia and the neglect of the disease, certain medications, physical therapy, or surgery are prescribed.
Are Spigelian hernias dangerous?
Any hernia can cause complications if left untreated. Because a Spigelian hernia goes through a narrow opening and has rigid edges, the omentum or intestine can get stuck. This can lead to dangerous complications:
- Conversion to a pinched hernia. The bowel or omentum becomes stuck in the cleft and blocks access to a normal blood supply. Without natural blood flow, the tissue will gradually die off, which can lead to irreversible consequences for the patient.
- Conclusion. This occurs when part of the muscle tissue or intestine becomes embedded in the hernia sac. Impingement occurs in 27% of cases of Spigelian hernia.
- Obstruction. A complication occurs when a loop of the intestine gets stuck in a narrow opening, resulting in an accumulation of undigested food. In turn, there may be the intoxication of the entire body.
As you can see, a Spigelian hernia is quite a serious disease that can lead to dangerous consequences. Therefore, do not delay going to the doctor if you experience painful sensations in the abdominal area.
How is a Spigelian hernia treated?
In most situations, a hernia is treated surgically. Depending on the complexity of the disease, conventional surgery or laparoscopic correction is performed. In the first case, the doctor will pre-determine a tear in the fascia, and perform a Spigelian hernia reduction - pushing part of the intestine or omentum into place. After that, he will carefully sew up the incision site.
With laparoscopic correction, the surgeon makes only 1-2 small incisions on the abdomen and uses special devices to push the stuck parts of the intestine or omentum back into place. Such an operation is less painful and safer. In addition, it takes much less time for the body to recover.
Remember, the earlier you schedule surgery to remove a Spigelian hernia, the better your chances of avoiding dangerous complications. For example, if there is a pinch or obstruction, you will need urgent surgical intervention. As soon as you have the first signs of the disease, do not delay, urgently contact your doctor.
Recovery from surgery
After surgery, the incision sites will be sore for a while. Also, some patients feel discomfort in the abdomen. To avoid painful sensations, the attending physician prescribes pain medication. After about 5-7 days, the wound is removed from the stitches or dressing, if it is well healed and not inflamed. After that, you should avoid heavy physical activity for a month. Do not put pressure on the cut, do not lift weights, and, preferably, do not drive.
During this time, however, you can begin to do gentle exercises for a Spigelian hernia. They are performed slowly, without much effort. Choosing a competent course will help the attending physician. Do not try to choose your exercises - this can lead to a new hernia and possibly the need for a new surgical intervention. You should always consult your doctor in the postoperative period. If the painful symptoms do not go away, contact your specialist immediately.
Frequently Asked Questions
Especially for our readers, we have prepared a section with answers to frequently asked questions about Spigelian hernia.
What is a Spigelian hernia and what are its causes?
This is the name given to a form of ventral hernia in which the Spigelian fascia bulges out through a narrow opening, forming a Spigelian aponeurosis. This defect occurs most often in the elderly. Also, a Spigelian hernia can occur as a result of a past illness or regular intra-abdominal pressure caused by a severe cough or chronic constipation.
What does a Spigelian hernia look like and where is it located?
Spigelian hernia is much rarer than other types of hernia. It is quite difficult to identify it because it develops between the fascial tissue and the abdominal wall muscles and is small - 1-2 cm. Sometimes these types of hernias are diagnosed by the appearance of a bulge, which is usually near the navel in the lower abdomen.
Are Spigelian hernias painful?
It depends on the stage of the disease and the individual characteristics of the patient. In some cases, there are no painful symptoms. In other people, when a hernia occurs, severe pain is felt, which has a permanent nature.
Where do Spigelian hernias occur?
Such an ailment most often affects the muscle tissues of the anterior abdomen. Also, a hernia can develop on internal organs. For example, on the intestines or appendix.
Can a Spigelian hernia cause back pain?
This is unlikely, but some patients may indeed complain of back pain. This is usually due to pain "recoil" from internal organs or abdominal muscles.
Can a Spigelian hernia cause constipation?
Constipation can act as a complication of a hernia. This symptom occurs when a loop of the intestine gets stuck in a narrow opening and undigested food begins to accumulate. As a result, the patient suffers from regular constipation.
Do all Spigelian hernias need surgery?
Only a doctor can correctly diagnose a Spigelian hernia and choose the right treatment after conducting all the necessary checks. Depending on the degree of the disease, surgical intervention or laparoscopic correction is prescribed. Therefore, only your doctor, based on your case, will be able to answer the question "is surgery necessary for Spigelian hernias?"
Are the symptoms of a Spigelian hernia different in women and men?
No, the symptomatology of the course of the disease does not depend on the sex characteristics at all. Most often the first signs of a hernia are a pain in the abdominal area. They appear when lifting weights, with regular constipation, and with a chronic cough. Some patients have a small bulging bump in the abdomen near the navel.
How to treat a Spigelian hernia?
Do not self-medicate under any circumstances! It can only aggravate the situation! At the first symptoms of the disease, it is necessary to go to a proven medical institution. There, the attending physician will check your condition according to external signs, prescribe computer diagnostics or ultrasound examination, and only after receiving the results will prescribe a competent treatment.
Do I have a spigelian hernia?
It is quite difficult to detect this disease on your own. First of all, you should be alerted to constant pain in the abdomen. They may intensify when you lift something heavy, play sports, or cough heavily. Frequent constipation can also indicate a Spigelian hernia. Another sign of the occurrence of the disease is the formation of a small bulge on the abdomen. If you notice even one symptom, you should urgently consult a doctor.
Spigelian hernia is a serious disease that can cause irreversible consequences for the human body. Do not think that the ailment will go away on its own. It must be treated urgently and in no case on its own. So, there is a risk of causing more harm to yourself! To notice the disease in time, we recommend regular medical examinations. This is especially true if you notice a deterioration in your well-being.