Spigelian Hernia
Definition
Spigelian hernia is a type of hernia that occurs through the spigelian fascia, which is the aponeurotic layer between the rectus abdominis muscle and the semilunar line.
Types
- Direct Spigelian Hernia: Occurs through a direct defect in the spigelian fascia.
- Indirect Spigelian Hernia: Occurs through a hernia sac that protrudes through the spigelian fascia and into the preperitoneal space.
Causes
- Aging: Weakness of the spigelian fascia with age.
- Obesity: Increased intra-abdominal pressure.
- Trauma: Direct injury to the abdominal wall.
- Chronic cough: Increased intra-abdominal pressure.
Clinical Features
- Pain: Pain or discomfort in the lower abdomen.
- Mass: A palpable mass in the lower abdomen.
- Intolerance: Intolerance to physical activity.
Investigations
- Imaging studies: CT or MRI scans to confirm the diagnosis.
- Physical examination: Palpation of the hernia and assessment of the patient's overall health.
Complications
- Strangulation: Compression of the herniated contents.
- Necrosis: Death of the herniated contents.
- Incerceration: Entrapment of the herniated contents.
Management
- Surgical repair: Repair of the hernia through an open or laparoscopic approach.
- Hernia mesh: Use of a mesh to reinforce the repaired area.
Treatment
- Preoperative care: Optimization of the patient's overall health before surgery.
- Postoperative care: Monitoring of the patient's recovery and management of any complications.
Blood Supply
- Superior epigastric artery: Supplies the rectus abdominis muscle and the spigelian fascia.
- Inferior epigastric artery: Supplies the rectus abdominis muscle and the spigelian fascia.
Nerve Supply
- Iliohypogastric nerve: Supplies the abdominal wall.
- Ilioinguinal nerve: Supplies the abdominal wall.
Clinical Anatomy
- Spigelian fascia: The aponeurotic layer between the rectus abdominis muscle and the semilunar line.
- Semilunar line: An imaginary line that marks the lateral edge of the rectus abdominis muscle.
Homoeopathic Therapeutic Medicines
- Calcarea carbonica: Indicated for obesity and hernia.
- Natrum muriaticum: Indicated for chronic cough and hernia.
- Silica: Indicated for weakness of the abdominal wall and hernia.