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- acquired ventral hernia
- through the linea semilunaris
- the line where the sheaths of the lateral abdominal muscles fuse to
form the lateral rectus sheath
- nearly always found above the level of the inferior epigastric vessels
- most often occur where the semicircular line - fold of Douglas - cross the
linea semilunaris.
Presentation
- Commonly, the patient is over the age of 50 years.
- Men and women are equally affected
- pain
- localised to the hernial site
- aggravated by any movement that raises intra-abdominal pressure
- Later becomes more dull, constant, and diffuse.
Examination
- soft, reducible mass may be present in the lower abdominal area
- disappears on pressure
- hernial orifice can usually be palpated when mass reduced
- Diagnosis is more difficult when the hernia dissects within the layers of
the abdominal wall - internal and external obliques - or may be located at a
distance from the linea semilunaris.
Investigation
- Ultrasound and CT scan may help to confirm the diagnosis.
Treatment
- primary aponeurotic closure.
- Spigelian hernias have a high incidence of incarceration and should be
repaired.
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