scholarly journals A case of incarcerated spigelian hernia causing small bowel obstruction

2020 ◽  
Vol 7 (12) ◽  
pp. 4238
Author(s):  
Ravi Kumar Sabu Murugesan ◽  
Kannan Ross ◽  
Joyce Prabakar
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Physical Examination ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Spigelian Hernia ◽  
Obese Patients ◽  
Rectus Abdominis Muscle ◽  
Semilunar Line

Spigelian hernias are rare anterior abdominal wall hernias in which the defect occur at the semilunar line lateral to rectus abdominis muscle. It mostly occurs in the lower half as posterior sheath is deficient in that region. Spigelian hernias are rare and moreover it is difficult to diagnose clinically. It constitutes about 0.12% of abdominal wall hernias. Even though it is rare, it is more prone for complications. It affects both sexes and sides equally. It is a diagnostic difficulty especially in obese patients as in our case where physical examination will often be inconclusive. Majority of the spigelian hernias are diagnosed intra operatively. Here in this case report, we present a case of obese 48 years old female who presented with abdominal pain and signs of intestinal obstruction which was found out to be an incarcerated spigelian hernia. Recently laparoscopic repair has been found to be safe and effective.

scholarly journals An unusual case of right iliac fossa lump-spigelian hernia: a case report

2021 ◽  
Vol 9 (1) ◽  
pp. 239
Author(s):  
Birma Ram ◽  
Manoj Gopinath ◽  
Saroj Chaudhary ◽  
Desymol Johnson
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Abdominal Wall ◽  
Preoperative Diagnosis ◽  
Unusual Case ◽  
Surgical Repair ◽  
Anterior Abdominal Wall ◽  
Iliac Fossa ◽  
Spigelian Hernia

Spigelian hernia is a relatively uncommon hernia of anterior abdominal wall, occurring in different anatomical tissue planes. It is a variant of inter-parietal hernia. Preoperative diagnosis of obstructed inter-parietal hernia is based on imaging. Once correctly diagnosed it is easily amenable to surgical repair. We present a case of Spigelian hernia presenting as right iliac fossa lump with features of small bowel obstruction.

scholarly journals CHRONIC NON-CANCER ABDOMINAL WALL PAIN AMELIORATION VIA PHENOL NEUROLYSIS BY TRANVERSUS ABDOMINIS PLANE APPROACH: A CASE REPORT

2019 ◽  
pp. 127-130
Author(s):  
Heath McAnally
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Case Reports ◽  
Tap Block ◽  
Abdominal Wall Pain ◽  
Chemical Denervation ◽  
Chronic Abdominal Wall Pain ◽  
Noncancer Pain

Abdominal pain is common and has multiple etiologies. We present a case of chronic abdominal wall pain that was treated with phenol neurolysis via a tranversus abdominis plane (TAP). To date, only 4 case reports utilizing TAP neurolysis have been reported and all were performed in the context of malignancy-related pain. The TAP block has become an integral component of the regional anesthesiologist’s perioperative anesthesia and analgesia arsenal. In summary, chemical denervation of the anterior abdominal wall is feasible and efficacious in palliating chronic non-cancer pain via a TAP block technique. Key words: TAP, transversus abdominal plane, phenol, abdominal wall pain, neurolytic, noncancer pain

scholarly journals Computed tomographic colonography: Diagnosis of an incarcerated Spigelian hernia

2014 ◽  
Vol 18 (1) ◽  
Author(s):  
Joel H. Bortz
Keyword(s):  
Small Bowel ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Abdominal Discomfort ◽  
Spigelian Hernia ◽  
Computed Tomographic Colonography ◽  
Rare Form ◽  
Lateral Deviation ◽  
Computed Tomographic

A 68-year-old obese man underwent computed tomographic colonography (CTC) scanning to investigate worsening constipation and lower abdominal discomfort on his left side.Optical colonoscopy was contraindicated because of his comorbidities. A preliminary CTC diagnosis of incarcerated Spigelian hernia was made, based on lateral deviation of thesigmoid colon to the left as well as extrinsic impressions on it, and the central location of the small bowel. Spigelian hernia is a rare form of anterior abdominal wall hernia. CTC can play a role in its diagnosis.

scholarly journals Anterior abdominal wall ‘peritoneal recess’: cause for pseudoherniation of small bowel resulting in chronic abdominal pain

2013 ◽  
Vol 95 (2) ◽  
pp. e23-e25 ◽  
Author(s):  
K Siddique ◽  
K Slaven ◽  
A Samad
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Rectus Sheath ◽  
Chronic Abdominal Pain ◽  
Aged Patient ◽  
Middle Aged ◽  
Abdominal Symptoms

A middle-aged patient presented with intermittent chronic abdominal pain without any obvious cause. Computed tomography detected a hernia (presumed to be the cause of the patient’s symptoms) without any obvious lump on examination. A laparoscopy was performed to repair the hernia. This revealed a left-sided unilateral ‘peritoneal recess’ at the level of the arcuate line extending medial to the linea semilunaris. No extraperitoneal sac or defect was noted in the rectus sheath or in the muscle, nor were any contents present in the recess at the time of the laparoscopy. We believe the bowel was being trapped intermittently in this space, causing the abdominal symptoms.

scholarly journals A227 UMBILICAL HERNIA INCARCERATION IN LIVER CIRRHOSIS: A RARE COMPLICATION OF PARACENTESIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 263-265
Author(s):  
A LAGROTTERIA ◽  
A Aruljothy ◽  
K Tsoi
Keyword(s):  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Large Volume ◽  
Umbilical Hernia ◽  
Rare Complication ◽  
Abdominal Wall Hernia ◽  
Refractory Ascites ◽  
Large Volume Paracentesis

Abstract Background Patients with decompensated liver cirrhosis with ascites frequently have umbilical hernias with a prevalence of 20% and are managed with large volume paracentesis (LVP). Common complications of LVP include hemorrhage, infection, and bowel perforation that occur infrequently with a frequency of less than 1%. However, incarceration of umbilical hernias has been reported as a rare complication of LVP and is speculated to be from ascitic fluid decompression that reduces the umbilical hernia ring diameter resulting in entrapment of the hernia sac. It is unclear whether the quantity or the fluid removal rate increases the herniation risk. Based on case series, this rare complication occurs within 48 hours of the LVP and requires emergent surgical repair and involves a high risk of morbidity and mortality due to potential infection, bleeding, and poor wound healing. Aims We describe a case report of an incarcerated umbilical hernia following a bedside large-volume paracentesis. Methods Case report Results A 59-year-old Caucasian male presented to the emergency department with a 24-hour history of acute abdominal pain following his outpatient LVP. His medical history included Child-Pugh class C alcoholic liver cirrhosis with refractory ascites managed with biweekly outpatient LVP and a reducible umbilical hernia. He reported the onset of his abdominal pain 2-hours after his LVP with an inability to reduce his umbilical hernia. Seven liters of clear, straw-coloured asitic fluid was drained. Laboratory values at presentation revealed a hemoglobin of 139 g/L, leukocyte count of 4.9 x109 /L, platelet count of 110 xo 109 /L, and a lactate of 2.7 mmol/L His physical exam demonstrated an irreducible 4 cm umbilical hernia and bulging flanks with a positive fluid wave test. Abdominal computed tomography showed a small bowel obstruction due to herniation of a proximal ileal loop into the anterior abdominal wall hernia, with afferent loop dilation measuring up to 3.4 cm. He was evaluated by the General Surgery consultation service and underwent an emergent laparoscopic hernia repair. There was 5 cm of small bowel noted to be ecchymotic but viable, with no devitalized tissue. He tolerated the surgical intervention with no post-operative complications and was discharged home. Conclusions Ultrasound-guided bedside paracentesis is a common procedure used in the management of refractory ascites and abdominal wall hernia incarceration should be recognized as a potential rare complication. To prevent hernia incarceration, patients with liver cirrhosis should be examined closely for hernias and an attempt should be made for external reduction prior to LVP. A high index of suspicion for this potential life-threatening condition should be had in patients who present with symptoms of bowel obstruction following a LVP. Funding Agencies None

New data of topographic anatomy of semilunar line (semilunar line by A. Spiegel)

2021 ◽  
pp. 70-72
Author(s):  
A. V. Chernykh ◽  
M. P. Popova ◽  
V. Yu. Brigadirova
Keyword(s):  
Anterior Abdominal Wall ◽  
Abdominal Muscle ◽  
Spigelian Hernia ◽  
Diagnosis And Treatment ◽  
Body Type ◽  
Anatomical Dissection ◽  
Line Region ◽  
Semilunar Line ◽  
Location Type ◽  
Variant Anatomy

Background. Today, a special place in surgical practice is the treatment of patients with spigelian hernias, which can be subcutaneous, interstitial, prepperitoneal, and make up 1% of all external hernias of the abdomen. The difficulty in diagnosing of spigelian hernias can lead to a serious complication – infringement of the hernia, which will require emergency surgical treatment. Therefore, the study of the typical, sexual and variant anatomy of the Spigelian line region is important in improving the diagnosis and treatment of such patients.The aim. To study the features of typical, sexual and variant anatomy of the Spigelian line region.Materials and methods. We examined 42 non-fixed corpses of persons of both sexes without signs of pathology of the anterior abdominal wall. Among them were 26 (54.2%) men and 22 (45.8%) women. At autopsy, we performed anatomical dissection of the semilunar line region. We measured the width of the aponeurotic stretch from the end of the transverse abdominal muscle fibers to the lateral edge of the rectus abdominis muscle at level corresponding to d. bicostarum, umbilical ring and d. bispinarum.Results. We identified four clusters corresponding to the variations in the shape of the semilunar line: tapering down (9.5%), uniform wide (19.0%), tapering up (28.6%) and wide in the middle (42.9%). We found that the semilunar line, tapering up, was significantly more often observed in women (83.3%), uniformly wide – in brachymorphic body type (75.0%), wide in the middle – in mesomorphic body type (66.07%), and the semilunar line, tapering down, was found only in men. Variants of the shape of the semilunar line, tapering up or down, were absent in persons of the brachymorphic body type. Semilunar line, tapering up, was found (without significant differences) in persons of the mesomorphic body type in 41.6%, in the persons of the brachymorphic body type – in 58.4%, and semilunar line, tapering down, was noted in persons with a dolichomorphic body type in 75.0%.Conclusion. New data may allow to predict the location, type of spigelian hernia, and also improve the diagnosis and treatment of spigelian hernia.

Sign in / Sign up

Export Citation Format

Share Document