Named for the Flemish anatomist Adrian van der Spieghel (1578-1625), Spigelian hernias are most commonly located in the Spigelian belt (“S belt”), a 6-centimeter horizontal region below the navel and to the side of the abdominal muscles.
Spigelian hernias are commonly found in patients around 50 years of age and are more common in men than in women. They also occur more often on the right side than on the left side of the abdomen.
Patients who have this type of hernia may feel pain or a bulge in the abdominal area. If left untreated, the hernia may become strangulated, which could lead to bowel obstruction. Unless a significant medical condition prevents it, all hernias should be repaired with surgery. In this case, a simple closing of the fascia (connective tissue of the abdominal wall) with sutures can repair the hernia.
A plain abdominal x-ray showing intestinal obstruction in a patient with a Spigelian hernia. The white mass at the bottom is the cat scan contrast in the urinary bladder.
A CAT scan of an incarcerated left Spigelian hernia. Note the air above the fascia on the patient's left side.