

Spigelian hernia

A Spigelian hernia is a type of abdominal hernia.


They are rare and account for ~1% (range 0.1-2%) of ventral hernias 2-3. The incidence is thought to peak at around the 4th to 7th decades. There may be a slightly increased female predilection with a male to female ratio is 1:1.18 3.


They may be congenital or acquired.


The hernial orifice of a Spigelian hernia is usually located along the semilunar line (Spigelian line) through the transversus abdominis aponeurosis (Spigelian fascia), close to the level of the arcuate line. The majority of Spigelian hernias are found in a transverse band lying 0-6 cm cranial to a line running between both anterior superior iliac spines referred to as the Spigelian hernia belt.

Radiographic appearance

The diagnosis of a Spigelian hernia at times presents greater challenge than its treatment. The clinical presentation varies, depending on the contents of the hernial sac and the degree and type of herniation. The pain, which is the most common symptom, varies and there is no typical pain of a Spigelian hernia. Findings to facilitate diagnosis are palpable hernia and a palpable hernial orifice.


Ultrasound can be recommended for verification of the diagnosis in both palpable and nonpalpable spigelian hernia.



Treatment and prognosis



Although it is named after Adriaan van Spieghel (Belgian anatomist), who described the semilunar line, the hernia was thought to be first described by Klinkosch in 1764 3.

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