Lumbar hernia
This type of hernia appears in the lumbar region, emerging through weak spots in that area, the so-called lumbar triangles:
- The inferior triangle, known as Petit’s triangle, is located between the latissimus dorsi muscle, the external oblique abdominal muscle, and the iliac crest.
- The superior triangle, known as Grynfeltt’s triangle, is located between the quadratus lumborum muscle, the internal oblique abdominal muscle, and the 12th rib.
Parastomal hernia
This is a type of postoperative hernia that appears at the site of the stoma, where the integrity of the abdominal wall was disrupted in order to bring it out.
Spigelian hernia
A Spigelian hernia is a rarely occurring hernia. It is a defect (hole) in the anterior abdominal wall, located 4-5 cm below the navel, to the left or right of the midline of the abdomen.
It presents with periodic discomfort, pain, and/or a bulge in the abdominal wall, which appears in an upright position and during physical exertion and disappears when lying down.
In some cases, an examination by a surgeon is enough to diagnose the hernia, but often, in overweight patients and/or with a small hernia, this is not possible. In that case, the patient is referred for an ultrasound examination of the abdominal wall, a CT scan, or an MRI.
Treatment of a Spigelian hernia is exclusively surgical.
There are two surgical methods: conventional (with an incision in the area of the hernia) and laparoscopic (with several small incisions of 5-10 mm in the abdominal wall).
For small hernias, simply suturing the defect (hole) is enough; for larger ones, placing a mesh is mandatory.
The complication that can occur with a Spigelian hernia (as with all other hernias) is incarceration. Incarceration involves severe pain in the area of the defect (hole); if there is a bulge, it is very painful and does not disappear regardless of body position. Nausea, vomiting, abdominal bloating, and inability to have a bowel movement appear. This condition requires emergency surgical treatment, that is, within a few hours of the diagnosis. In emergency surgery, part of the bowel may even have to be removed if you waited too long before seeking help from a surgeon. Therefore, the earlier the hernia is diagnosed and operated on, the easier the recovery period is and the sooner you return to your usual daily routine.
This type of hernia bears the name of the Flemish anatomist Adriaan van der Spieghel, who described the semilunar line of the abdominal wall, which coincides with the outer edge of the rectus abdominis muscle. It is precisely there, at the level of the navel and a few finger-widths below it, that this rare hernia appears.
Location where a Spigelian hernia appears
Hiatal hernia
A hiatal hernia is the entry of part of the stomach into the chest cavity through the natural opening of the diaphragm through which the esophagus passes. In the part of the stomach located in the chest cavity above the diaphragm, a zone of increased intracavitary pressure develops, which strongly lowers the tone of the lower esophageal sphincter and favors more frequent backflow of stomach contents into the esophagus, and hence a higher frequency of episodes of GERD (gastroesophageal reflux disease). A hiatal hernia can be of various sizes. When the herniated part of the stomach is large, it can press on the heart and provoke rhythm disturbances, which is why patients with a hiatal hernia often turn to a cardiologist without having any cardiac problems.
The clinical picture is particularly dramatic in the case of incarceration, and emergency surgery is required. The method of choice in the treatment of hiatal hernia and GERD is laparoscopic Nissen fundoplication.
On this page, you can change your choices at any time after you have read and understood our