Spigelian hernia

Spigelian hernia, also known as hernia spiegelihernia spigeli or lateral ventral hernia, is a type of abdominal hernia along the semilunar line, resulting in herniation between the muscles of the abdominal wall.


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.

A spigelian hernia is associated with the ipsilateral cryptorchidism among 75% male infants 5.

Two hypotheses has been proposed to explain the association, but the exact hypothesis is always a debate


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.


The hernial orifice and sac can be well demonstrated by computed tomography, which gives more detailed information on the contents of the sac than does ultrasonic scanning.

Treatment and prognosis

The treatment is often surgical and the risk of recurrence is small.

History and etymology

Although it is named after Adriaan van den 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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