Pediatric lateral ventral (spigelian) hernias.

Lateral ventral (spigelian) hernias may not be recognized if the physician is unaware that they can occur in pediatric patients. Diagnosis depends on finding a protrusion in the spigelian fascia lateral to the rectus sheath at the junction of the arcuate and semilunar lines, below the umbilicus. We report nine such cases, to bring the total number of recorded pediatric cases to 18. Surgical repair involves a layered overlapping closure using interrupted nonabsorbable sutures. Since the rim of the defect is extremely difficult to outline once the child is asleep and relaxed, it must be outlined in indelible ink while the child is awake and straining.