What is a Spigelian Hernia?

A spigelian hernia occurs in between abdominal wall muscles.
Surgery may be required to treat a spigelian hernia.
A spigelian hernia usually does not develop before the age of 40, and is more likely to occur after the age of 50.
A spigelian hernia can cause a large amount of damage if left untreated.
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  • Written By: Malcolm Tatum
  • Edited By: Bronwyn Harris
  • Last Modified Date: 13 November 2014
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Sometimes known as a lateral ventral hernia, a spigelian hernia is a type of hernia that develops through the spigelian fascia. Unlike many hernias that thrive just below layers of fat, a spigelian hernia occurs in between the muscles found in the abdominal wall. Because of the nature of this type of hernia, there is often little outward evidence of swelling, making it possible for the health issue to go undetected for longer periods of time.

Often beginning somewhere along the linea semilunaris, a line of tissue situated on each side the rectus abdominis, the causes for this condition are similar to the health issues that lead to most other types of hernias. The condition may develop due to a weakening of the abdominal wall later in life, injury, or prolonged periods of physical stress. Men and women tend to exhibit an equal opportunity to experience a health condition of the nature. Unlike other hernias, the spigelian kind can often be mistaken for some other type of abdominal problem.

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There are a few symptoms that may indicate the presence of a spigelian hernia. Recurring pain in the immediate area, following by a period of constant, dull pain is a common indicator. A sudden decrease in the proper function of the bowels, especially one that lasts for more than a day or two, is also a strong sign. While the protrusion may be very small, it may be visible in people with relatively little fat in the abdominal area and will tend to be soft to the touch.

The most common treatment for this condition is to undergo surgery to repair the damage caused. Depending on the severity of the damage, the surgeon may utilize some type of mesh to reinforce the weakened abdominal wall and thus decrease the opportunity for a recurrence.

It is important to note that a hernia of this type can cause a great deal of damage if left untreated. The spigelian hernia may develop in a location where the bowels are in effect strangulated, or cause some type of obstruction in the colon. Both these situations can lead to the deterioration of both organs and eventually cause complete failure

Fortunately, a spigelian hernia is a relatively rare occurrence. In most instances, the condition does not develop before the age of 40 and is more likely to occur after the age of 50. The hernia is also more likely to develop on the right side of the abdomen rather than the left.

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anon969635
Post 21

I had a spiligan hernia on my left hand side. It was not picked up on a ultra scan, however was on a ct scan. I had the operation and was kept in for two days. It was the side of a rugby ball. Everything was going well, then five weeks later, I got an infection, which caused an opening to my left hand side of the tummy (on the scar) where they did the hernia, well this week, my area where the hernia.was is back again and I am in so much pain, sometimes it's in one area, other times it's across my stomach. People have noticed the big lump back and my district nurse has also said it's a hernia, so all this for nothing. Has anyone else's ever come back? What did you do?

anon357926
Post 20

@post 16: My pain symptoms were the same as yours: dull and hard to pinpoint, into a sharp pain that woke my in the night. I was referred to a gastroenterologist who recognised it was most likely a muscular issue and I had a specialist ultrasound scan that found the spegilian hernia. From this I was referred to the surgeon who laparoscopically repaired it.

anon357920
Post 19

I'm a 31 year old female who experienced pain in the left side of my stomach wall sporadically over six months. Once I found the right surgeon, it was diagnosed and operated on very quickly.

However, it was day surgery and I am now three and a half months after the operation. I can feel a small lump in the site of one of the corners of my mesh and after activity (being very light, carrying shopping or walking for a long time) I will feel a stabbing pain at that site.

I'm seeing my surgeon again soon, but I just wandered if anyone else was still experiencing pain on exercise this long after the surgery? I am aware every has a different rate of recovery but I am finding it slow and frustrating given I was very active before training at least four or five times a week.

anon342754
Post 18

I am amazed that so any people have this, yet they say it's rare. I don't think it's rare anymore. My husband is fighting doctors for five years! Each doc says it's a pulled muscle. It's on his right side, and he's had a CT scan, X-ray, ultrasound, and tons of blood tests. His pain and symptoms sound like a spigelian hernia. We both are at wits end. What do we do, who do we see?

anon255292
Post 17

Has anyone ever heard of a spigelian hernia going undetected even in a laparoscopic procedure?

anon241154
Post 16

I am a 33 year old, average weight female who is typically very active, lifts heavy objects, and has sat in a harness doing construction/climbing for long periods.

For the last six months or a year, I have occasionally felt a tingling in my right external oblique area (you know, where the love handles slowly develop as we age). I am going to start tracking the occurrence rate, but it seems to happen every couple of days, maybe once a week. It has not been sharp pain that I recall. I do not have any tenderness with point pressure applied. I came upon this blog and other info about spigelian hernias and hoped I could get some feedback on symptoms and a doctor's advice.

Has anyone experienced similar dull symptoms before having sharp pains?

Could this just be a tear of the obliques? And not a hernia?

If I were to see a specialist, what kind would I look for? Title?

anon192931
Post 15

This is anon190389. I had the surgery a few days ago, laparoscopic. Very painful, but every day gets better. The hernia was pushed back in with mesh to keep in place. I spent the night in the hospital, which turned out to be a good thing. It was very hard to get around and use the bathroom for first 24 hours.

I came home late the next day. I had a terrible experience in the hospital in that I didn't sleep one single second due to pain, and my roommate. When I got home, I went to bed at 11 p.m. and slept two or three hours at a time, but I did sleep. The next day, I felt better, and today even better. Hope I never have to go through this again. But I would do it again, to avoid further complications. -- Cleveland, Ohio

anon190389
Post 14

I have had constant back and side pain for over 15 years. My gallbladder was removed, ovary removed and a thoracotomy to remove a cyst from the spine. All this and I still have the pain. This week I found a lump on the right side, associated again with all the pain. The pain become so much worse in the last five weeks, more than ever. I was rubbing my right side stomach area felt a rather large lump. I called the doctor the next day. The receptionist said it sounded like a hernia. I got an appointment for 10 days from then.

The next day, the doctor called and got me in the next day. He said I have a spigelian hernia, and a recent CT scan confirmed it. I am scheduled for surgery in a few days. He said a laparoscopy but everyone else said it will probably be open. I am not sure what to expect. If the pain in the side and back go away, I don't care.

Since he examined me, the pain has increased over 60 percent. I guess just moving it around makes it worse. I just wanted to tell everyone my story and thanks for all your info. I'll keep you updated. --t in Cleveland, Ohio

anon176648
Post 13

I had a tram flap surgery 10 years after my modified radical mastectomy.I waited to make sure it had been around long enough that they knew what they were doing (wrong!) I developed three subsequent left lateral spigelian hernia. I am about to fix it a fourth time. crazy? It will be an open procedure as it is large.

This is a new surgeon and he says it will be fixed for the last time. hope he's right!

anon174645
Post 12

I just had open surgery for this. In and out of the hospital in about four hours. Sent me home with Vicodin.

Every time I fell asleep I'd stop breathing and wake up gasping for air. Quit taking the narcotics and switched to Ibuprofen and everything was fine.

Had to sleep in the recliner for almost a week (couldn't lie down because it hurt so bad) and couldn't really get up or down for five or six days, but after that it was great.

They should keep you in the hospital for a day to make sure you don't react to the narcotic pain relievers. It was crazy that they just sent me home an hour after I woke up. Within an hour of being home, I couldn't breath and had to concentrate very hard because my breathing was so shallow. They should watch you, especially when having the open surgery like I had.

After a week of pain, it starts dying down. Then you start feeling the incision pain for another week and then things start getting better.

Be sure to walk around as soon as you can. I stayed in the recliner for five days and started feeling fluid in my lungs so I had to get my butt up whether it hurt or not so I wouldn't get pneumonia. I just walked around town with an icepack for two weeks! Overall, it wasn't a stressful surgery at all, though.

anon169266
Post 11

Had adhesions five years ago and had emergency surgery to remove appendix and part of the bowel as they were gangrenous. The pain was excruciating. A month later I had a blockage and was in hospital again for 4 days but bowel unblocked so did not need surgery. May 2010 I was in again with a twisted bowel but no surgery again as it untwisted on its own so was home after four days. I have had discomfort on and off for over four years on the right side of my abdomen and it was diagnosed as a Spigelian Hernia but if it gave no trouble to leave it.

In the last month it has become more uncomfortable and some pain at times accompanied by diarrhea. Had a blood test and now awaiting a scan. My mind is working overtime worrying it may be something more sinister!

anon165951
Post 10

I had open surgery for a spigelian hernia two weeks ago. I had suffered a dull ache over my left hip for about two years and because I have a talent for developing ovarian cysts, it was just presumed that they were causing this ache.

A CT scan showed that my hernia was quite large with bowel and fat trapped. The operation went very well but unfortunately now I have a hematoma (a large one) under the scar that I had drained two days ago. 120 mls was sucked out -- instant relief!

Now that fluid is back and the doctors want to wait and see if my body will dissolve this mass or not. This has been more painful and annoying than the hernia! Grrr. I just want to get back to work but bending, lifting and standing for any length of time is painful.

anon146580
Post 9

Three weeks ago I had a Spigelian hernia repair and my gall-bladder removed at the same time. I remember the exact moment my hernia started. I'd done nothing strenuous and was just walking to the kitchen when I felt a 'pop' and had a sharp pain rather like a stitch you get after running, that was 18 months ago.

I have had no problems whatsoever with the gall-bladder removal, but have been in quite a bit of pain where the hernia was although of course I am getting more mobile each day. I went back to see the surgeon today and was told that everything is fine.

One good thing though: I've had a continuous back-ache over the last year but since the op I've had none whatsoever. I was told that it was the hernia that was causing it.

anon132489
Post 8

I had repair of a right-sided spigelian hernia at the age of two. This was over 50 years ago and my mother remembers it being 'the size of a football', so presumably the bowel was strangulating and swelling grossly.

I still have a slightly indented scar which is noticeable (probably more so to me than others) but the abdominal skin and muscle seems to 'hang' annoyingly over the scar. Still this is a small price to pay. Other than that, I've suffered no side effects.

anon114209
Post 7

I am one week out of open surgery for this spigelian hernia and other than discomfort when moving, I am recovering well and expect to playing golf again in one month. I am a 67 year old male.

anon113526
Post 6

I've been to so many doctors saying different things. now they are thinking this is what I have so now they are sending me to a surgeon to see if this is what the problem is.

anon98405
Post 5

I just had this procedure completed today. Laprascopic, outpatient procedure.

Surgery started at 7:30 and by 10:30 am I was home.

I live in Phoenix and had a great surgeon, Dr. Jeffrey Singer.

I am in a lot of pain at times and he said no activity for two weeks, and not to lift anything for 30 days. By the way I had this for almost three years before it was diagnosed and I am a 36 year old female.

stephanie235
Post 4

I just came home from the ER and will have to have surgery in a few days ago to repair my spigelian hernia. There is such confusing information out there about these types of hernias.

I was hoping someone who has had open (as I have been told my surgery will be open) surgery could share their experience with me.

I do know (thankfully) that my bowels have not been strangulated and that my hernia is mostly fat.

I have been told if there aren't any complications, I will be in the hospital for three to five days. What concerns me is the recovery time. In March of 09 I had laparoscopic surgery to repair an umbilical hernia and it took almost a month and a half to recover.

With this one being open surgery and it being lower on my body I am very scared of the recovery time.

Anything you have to share will be greatly appreciated. Thanks

anon71510
Post 3

I recently had surgery for this. My hernia was on the left. My bowel had worked itself into the layers of the bowel muscle and over time created a tear.

I had symptoms of flu, fever, chills, abdominal pain, vomiting and headache. Fortunately it was found on a ct scan and my bowel was saved. I think prayers helped me through this, because it was probably there for some time, but happened very suddenly.

I did not have a resection and I did not receive mesh, as my surgeon stated he believed that mesh inside the bowel was prone to more infections. Surgeon recommended bed rest, no stress (yeah right!) and no lifting of over five lbs for five weeks.

I can't sit still, so I have had lots of pain. But I am trying to not do much because of the chance of recurrence. I would not suggest shoveling heavy loads of dirt if you know you have bowel issues.

anon41527
Post 2

the bowel could be entrapped through surgery or a weakness in the lateral abdominal muscle wall where the bowel could slip between the layers. therefore it would be very unlikely to happen suddenly, although it could be asymptomatic, and symptoms could develop only when the vasculature to the bowel became compromised.

anon34571
Post 1

does this hernia happen instantly or over time? for example, if I was shoveling dirt, would that instigate this hernia or does the body make the hernia?

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