Patient had right Spigelian hernia with ipsilateral cryptorchidism. He underwent hernia repair and right orchiectomy.
Spigelian hernia in is a sequale of maldescended testis (ectopic testis) and raised intraabdominal pressure purposed by ‘Raveenthiran’ (2005). This hitherto unrecognized sequence of event in a patient with Spigelian hernia and cryptorchidism named as “Raveenthiran syndrome” 1.
Different theory was proposed by Rushfeldt et al. (2010) to explain the cause of spigelian hernia, where failure of development of the gubernaculum followed by lack of inguinal canal and arrested testis result in hernia from the defect in the Spigelian fascia (Spigelian-cryptorchidism syndrome) 2.
Spigelian fascia is the aponeurotic tendon between oblique muscle laterally and the rectus muscle medially 3.
Spigelian hernias course anywhere along the Spigelian fascia and occurs due to torn transverse abdominis and the internal oblique aponeurosis. The external oblique tendon is intact 3.
Hernia is commonly located inferior to the arcuate line at the place where posterior recuts sheath is absent and is weakened by the penetration of sheath by the inferior epigastric vessels.