J Acute Care Surg.  2021 Mar;11(1):36-38. 10.17479/jacs.2021.1.36.

Laparoscopic Tissue Repair of an Acutely Incarcerated Spigelian Hernia

• Pillay Y
• Asefa R

• KMID: 2514227
• DOI: http://doi.org/10.17479/jacs.2021.1.36

Abstract

Spigelian hernias are a rare type of abdominal wall hernia. A weakness in the spigelian fascia causes abdominal contents to herniate between the abdominal muscle layers as an interparietal hernia. We present the case of a 72-year old woman with acute onset abdominal pain and distention. A computed tomography scan revealed an incarcerated spigelian hernia with small bowel obstruction. This necessitated an acute surgical intervention with a laparoscopic tissue repair. The case is unique as our patient had a large hernial neck measuring 4.8 centimeters, one of the largest in published literature. The laparoscopic tissue repair is outside the current norm for this type of hernial repair and remains a rare type of surgical herniorrhaphy. Laparoscopic ventral hernia repair in the acute setting should form part of the surgical skill set of acute care surgeons as borne out by the published literature and this case report.

Keyword

abdominal wall hernia; surgery; laparoscopic surgery; fascia