The usefulness of ultrasonography in the diagnosis of the Spigelian hernia.

Normally acquired, the Spigelian hernia is rare. Due to low incidence and frequent atypical presentations diagnosis is often difficult. Controversies exist about the diagnostic approach. We report our experience in two cases in which ultrasonography permitted a correct diagnosis of surgically confirmed Spigelian hernias. One of the two cases proved to be a carrier of bilateral Spigelian hernia at ultrasonography and at surgery. In our opinion ultrasonography represents the gold standard in the diagnosis of Spigelian hernias and we recommend its use as the first step in all cases of abdominal wall mass.