Spigelian Hernia

A hernia occurring anywhere in the linea semilunaris and above the inferior epigastric artery has been commonly named Spigelian hernia, after the Flemish anatomist Adrian van der Spigelius (1578-1625). The semi-lunar line demarcates the route along which the aponeurosis of the internal oblique muscle splits to enclose the rectus muscles. It extends from the lower costal margin to the pubic spine, lateral to the rectus muscle. The hernia is found most frequently below the umbilicus and may reach considerable size. Hernias below the inferior epigastric artery are classified as direct inguinal hernias. Although the occurrence of a Spigelian hernia is undoubtedly rare, more cases have been reported during the last 30 years than in the entire previous literature. Mersheimer and his associates¹ reported on 151 cases in 1951. Since then, isolated cases have been described which were diagnosed as a rule only during surgical exploration or after strangulation.^2-4