Zachariah Sanoop Koshy, Jose Priya
Department of General Gastrointestinal and Laparoscopic Surgery, Medical College, Kolenchery, Cochin, Kerala 682311, India.
Case Rep Surg. 2011;2011:491802. doi: 10.1155/2011/491802. Epub 2011 Oct 19.
Spigelian hernias are rare hernias, representing only about 1-2% of all abdominal hernias. An accurate preoperative diagnosis of this condition is often difficult because the physical presence of these hernias is often not demonstrable owing to its peculiar anatomic location. Many patients with Spigelian hernias, therefore, may have no obvious findings on clinical examination. The diagnosis is even trickier in obese patients wherein the hernia sac may lie in an intraparietal plane, masked by the abdominal subcutaneous fat. Here we describe a case of incarcerated Spigelian hernia where clinical and radiological findings were inconsistent and the accurate diagnosis was made by laparoscopy and was followed by a laparoscopic-assisted repair using an open anterior approach with an onlay mesh. We therefore feel that laparoscopy can be a useful tool for confirming the diagnosis and also for performing a definitive repair in doubtful cases of Spigelian hernias.
半月线疝是一种罕见的疝，仅占所有腹外疝的1%-2%。由于其特殊的解剖位置，这些疝的体征往往难以显现，因此准确的术前诊断常常很困难。因此，许多半月线疝患者在临床检查时可能没有明显发现。在肥胖患者中诊断更为棘手，因为疝囊可能位于壁内平面，被腹部皮下脂肪掩盖。在此，我们描述一例嵌顿性半月线疝病例，其临床和影像学表现不一致，通过腹腔镜检查做出准确诊断，随后采用开放前路加补片修补的腹腔镜辅助修复术。因此，我们认为腹腔镜检查可以作为确诊的有用工具，也可用于对可疑的半月线疝病例进行确定性修复。
