Spigelian Hernia: What Causes It?

When a hernia forms in the Spigelian fascia or Spigelian aponeurosis, this is known as a Spigelian hernia.

Man clutching his stomach as a reaction to pain

A hernia that occurs in the layer of tissue which separates two parts of the abdominal muscles is called a Spigelian hernia. So, what exactly causes this kind of hernia and what are the muscles affected? Learn all this and more here.

What is Spigelian Hernia?

When a hernia forms in the Spigelian fascia or Spigelian aponeurosis, this is known as a Spigelian hernia. The muscles involved are the lateral obliques and the rectus muscles. When left untreated, it results in fatal complications, which is why it is vital that an individual with this type of hernia get immediate treatment.

Symptoms

The symptoms vary from one individual to the next, and it also varies in severity. While others experience mild symptoms, others manifest severe symptoms. However, the common symptom is a bulge or lump to the side or below the belly button, which is soft to touch.

Other symptoms include intermittent or constant abdominal pain which varies per individual. Moreover, an individual may likely experience pain and discomfort when doing a specific activity such as the following.

  • Activities Involving Heavy Lifting
  • Bowel Movement
  • Exercise

An individual with a Spigelian hernia could also experience a decrease in bowel function. Other symptoms to be wary of are as follows.

  • Unexplained Soft Swelling in the Abdomen
  • Pain in the Abdomen When Coughing, Having a Bowel Movement, or Lifting
  • Pain in the Abdomen That is Unrelated to Illness, Other Common Disorders, or Food
  • Changes in Bowel Movement Like Bleeding When Defecating or Constipation

As mentioned above, if left untreated, then a Spigelian hernia is likely to cause a fatal complication. A hernia in the muscles affected blocks vital organs, and it results in the symptoms mentioned below.

  • The appearance of Blood in Stool
  • Absence of Bowel Movement for Days and is Accompanied by Severe Stomach Pain
  • Unbearable and Intense Abdominal Pain That Suddenly Occurs
  • Severe Pain Accompanied by Nausea and Vomiting

Causes

Like other forms of hernia, a Spigelian hernia is a result of weak muscles in the abdominal wall. This results in tissue and organs protruding through the weak muscles in the wall of the abdomen. However, this is not the only cause, and other factors may contribute to the development of a hernia.

Trauma and injury to the abdominal muscles after heavy lifting may also result in a hernia. Other cases also involve conditions which trigger chronic coughs like bronchitis, allergies, or the common cold. Excess amounts of fluid in the abdominal area also results in abdominal wall weakening. It is referred to as ascites.

While Spigelian hernias are rare, some individuals are at a heightened risk of developing this condition. Moreover, this type of hernia affects men more than women, and it is likely to affect men over the age of 50. Other factors that heighten the risk of Spigelian hernia include being overweight and being pregnant. Additional risk factors for developing a Spigelian hernia include the following.

  • Chronic Cough, Specifically COPD
  • Fluid in the Abdomen, Commonly Caused by Liver Problems
  • Frequently Straining to Lift Heavy Items or to Have a Bowel Movement
  • Trauma to the Abdomen Like a Major injury or Surgery

Diagnosis

If you think that you could have a hernia, then it is vital to seek immediate medical aid. However, if there is no discomfort or pain, then it is likely to live with the condition without treatment. Nonetheless, a Spigelian hernia causes extreme to mild pain, and it is a condition that resolves on its own. Surgery is definitely required.

Before treatment, diagnosis is vital which is done first with a physical examination. Your doctor would ask about the severity as well as the location of the pain. In addition, an imaging test is done to get a better look inside the body. Such imaging tests include a CT scan, an ultrasound, and an X-ray, which allow a close and detailed examination of the areas concerned.

Treatment

For Spigelian hernia, the only method of treatment is hernia repair surgery. However, the decision to opt for surgery is also based on the severity of pain and the size of the hernia. There are two options, one is an open surgery, and the other is a minimally invasive process.

In open surgery, the surgeon performs open mesh repair. An incision is made in the abdomen closest to the hernia. Afterward, the bulging tissue is removed, and the organs are returned to their proper location. Finally, the hole in the stomach wall is repaired.

As for the minimally invasive procedure, it is referred to as laparoscopic hernia repair. In this procedure, the doctor-in-charge creates a small incision in the abdomen. Then, the hernia is repaired with the aid of a thin surgical instrument that has a camera placed on its end.

Recovery

Whether open surgery or laparoscopic hernia repair is done, both processes are done on an outpatient basis. However, an individual may opt to stay for one night at the hospital after the procedure. The recovery for open mesh repair takes three to six weeks. On the other hand, recovery for laparoscopic hernia repair takes one to two weeks. Strenuous activity is ill-advised during recovery.

As for the risks involved, bruising and bleeding underneath the skin are likely to occur if an individual takes part in stressful activities. Much like any other surgical procedure, an individual is also at risk for infections. If you experience an increase in pain, fever, vomiting, and persistent bleeding after a hernia repair surgery, then it is recommended that you seek immediate aid from the hospital.

Complications

A Spigelian hernia, which if left untreated, results in life-threatening complications as well as significant damages. Hernias could also grow more prominent, which can lead to blockages in the bowel or blood supply loss to major organs. Such a complication involving obstructions is known as strangulation and is manifested by the following symptoms.

  • Severe Abdominal Pain
  • Nausea
  • Vomiting

Strangulation requires emergency surgery, and even if a Spigelian hernia does not cause pain or grow in size, doctors would always recommend hernia repair surgery.

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