ISSN: 2148-4902 | E-ISSN: 2536-4553
Northern Clinics of Istanbul Incarcerated Spigelian hernia: A rare cause of abdominal wall tender mass [North Clin Istanb]
North Clin Istanb. 2020; 7(1): 74-77 | DOI: 10.14744/nci.2018.09582

Incarcerated Spigelian hernia: A rare cause of abdominal wall tender mass

Ender Anilir1, Fatih Buyuker2, Salih Tosun2, Orhan Alimoglu2
1Department of General Surgery, American Hospital of Istanbul, Istanbul, Turkey
2Department of General Surgery, Istanbul Medeniyet University, Istanbul, Turkey

In this study, we aimed to present that incarcerated Spigelian hernia is an important cause of acute abdomen although it is rare and accounts for 1–2% of all abdominal wall hernias. Spigelian hernia arises from a defect in the aponeurosis of the transversus abdominis muscle, also known as the Spiegel fascia. This case analysis aims to present a Spigelian hernia case in which the sigmoid colon is incarcerated. The patient was referred to our emergency surgery clinic complaining of severe abdominal pain and a palpable mass in the left quadrant of the abdomen, presenting tenderness on the front abdominal wall. The symptoms suddenly emerged approximately eight hours ago before the patient was admitted to the hospital. The patient was taken into surgery after the ultrasonography (US) and computed tomography (CT) results suggested a preliminary diagnosis of incarcerated Spigelian hernia for which polypropylene mesh repair was performed. No recurrence was identified in the patient’s control examination performed 22 months later. Incarcerated Speigel hernia should be considered as a cause for patients developing sudden stomach ache and mass, causing tenderness on the front abdominal wall for which mesh repair should be performed.

Keywords: Incarceration, sigmoid colon; Speigel hernia.

Incarcerated Spigelian hernia: A rare cause of abdominal wall tender mass

Ender Anilir1, Fatih Buyuker2, Salih Tosun2, Orhan Alimoglu2
1Department of General Surgery, American Hospital of Istanbul, Istanbul, Turkey
2Department of General Surgery, Istanbul Medeniyet University, Istanbul, Turkey

Spigel herni tüm karın duvarı fıtıkları içerisinde %1-2 oranında görülen, spigel fasciası da denilen transversus abdominus kası aponörozundaki defektten kaynaklanan bir fıtık türüdür. Bu vaka analizinde sigmoid kolonun inkarsere olduğu bir spigel herni olgusunu sunmayı amaçladık. Hasta yaklaşık 8 saat önce ani başlayan şiddetli karın ağrısı ve batın sol kadranda, karın ön duvarında hassasiyet veren palpabl kitle yakınmalarıyla acil cerrahi kliniğimize başvurdu. Yapılan ultrasonografi ve batın bilgisayarlı tomografisi (CT) sonucunda inkarsere spigel herni öntanısı ile ameliyata alındı ve poliprolen mesh ile onarım uygulandı. Hastanın 22 ay sonrasında yapılan kontrollerinde rekürrens saptanmadı. Ani başlayan karın ağrısı ve karın ön duvarında hassasiyet veren kitle saptanan bir hastada inkarsere spigel herni de nedenler arasında düşünülmeli, mesh ile onarım uygulanmalıdır. (NCI-2018-0052.R1)

Anahtar Kelimeler: Spigel herni, inkarserasyon, sigmoid kolon

Ender Anilir, Fatih Buyuker, Salih Tosun, Orhan Alimoglu. Incarcerated Spigelian hernia: A rare cause of abdominal wall tender mass. North Clin Istanb. 2020; 7(1): 74-77

Corresponding Author: Ender Anilir, Türkiye
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