THE SO-CALLED SPIGELIAN HERNIA - A RARE L ATERAL VENTRAL HERNIA

A patient with Spigelian hernia is presented and the main pathological and clinical features are discussed. Its true incidence is probably g reater than the small number of patients reported in the literature, d ue to failure to recognize the clinical picture. A hernia through a de fect in the Spigelian fascia (aponeurosis of the transverse muscle of the abdomen) is called Spigelian hernia. The semilunar (Spigelian) lin e is defined as the line forming the transition from muscle to aponeur osis in the transverse muscle of the abdominal wall. It is a lateral c onvex line between the costal arch and the pubic tubercle. The part of the aponeurosis that lies between this semilunar line and the lateral edge of the rectus muscle is called the ''Spigelian fascia'' (correct : Spigelian aponeurosis). The hernia is located intramurally because t he hernia is covered by the aponeurosis of the external oblique aponeu rosis, so that both, the hernial sac and the orifice, can often not be detected by palpation. Clinical symptoms are not characteristic, but most patients have a distinct tender point above the hernial orifice.