Editorial

Spigelian Hernias Presenting as Surgical Emergencies

Authors: Emmanouil Zacharakis, MD, PhD, Ara Darzi, KBE, HonFREng, FMedSci

Abstract

Spigelian hernia is a rare partial abdominal wall defect in the transversus abdominus aponeurosis or spigelian fascia. It is located between the semilunar line (which marks the transition from muscle to aponeurosis in the transversus abdominis muscle) and the lateral edge of the rectus muscle, below the arcuate line of Douglas and usually above the inferior epigastric vessels, within a zone “clinically” named “spigelian hernia belt.”1 Adriaan van der Spieghel (1578–1625) was the first to describe accurately the semilunar line. Spieghel never described a hernia. He described the fascia through which this hernia occurs. The spigelian fascia is the aponeurotic part of the transversus abdominis muscle between the medial border of its muscular part and the insertion of the aponeurosis into the posterior rectus sheath.

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