Where are Spigelian hernias located?
The hernial orifice of a Spigelian hernia is located in the Spigelian fascia, that is, between the lateral border of the rectus abdominis muscle and the semilunar line, through the transversus abdominis aponeurosis, 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.
Multiple dilated loops of small bowel throughout the abdomen including faecalised ileal loops in the right lower quadrant. A transition point is identified within a right-sided Spigelian hernia which contains free fluid and a loop of distal ileum. The hernia measures 54 x 21 mm in axial plane with a 25 mm neck. No evidence of pneumoperitoneum.