Causes of Spigelian Hernia

Causes of Spigelian Hernia

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A spigelian hernia develops as a result of the passing of the abdominal organs through a defect in the muscular and aponeurotic layer of the anterior abdominal wall. The most typical location of such a defect is below the navel, closer to the iliac fossa on the right or left.

What is Spigelian Hernia?

A hernia is a condition whereby an organ presses out of the tissue or muscle holding it in place through a weak point on the wall. Spigelian hernia (likewise called lateral forward hernia) is a kind of hernia that occurs in the spigelian fascia, which is a tissue that separates two stomach muscles; the rectus abdominis (rectus muscles) and the semilunar muscle (lateral obliques). It is a rare type of hernia constituting 0.12% of all reported stomach hernias, and 1-2% of all reported hernias. This is since the stomach muscles are generally have sufficient strength and able to hold stomach organs in place.

Spigelian hernia is various from all other hernias. While other hernias develop below the subcutaneous fat layers, it is found between muscles of the abdominal area. It usually shows no external physical signs, like swelling. For this factor, it is not very quickly identified. It is usually detected after a long period of time when other abdominal problems occur. It needs to be treated instantly after medical diagnosis. If left unattended, it can lead to major constipation, bowel blockage and might cut off blood supply to some organs. This makes it a lethal condition.

Where is a Spigelian Hernia located?

Spigelian hernia develops in between the middle and lower abdominal area (on the lateral edge), through a layer of tissue called spigelian fascia which separates the 2 parts of the abdomen. The middle abdominal area is medically referred to as rectus abdominis while the lower part is called semilunar line.

What does a Spigelian Hernia seem like?

As spigelian hernias take place between muscles, they do not normally form the bulge that can be seen and felt through the skin as other hernias. This makes it tough to recognize its existence up until later on when it begins producing symptoms.

Sometimes, however, one has the ability to see and feel the bulge, especially when it is a big one. This is a high-risk stage that is accompanied by a lot of pain. The bulge is generally soft and inexplicable, on the abdominal area.


The most common symptoms of spigelian hernia are:

  • Constant or repeating burning pain in the abdomen
  • Increased pain when raising heavy things, coughing or having a bowel movement
  • Blockage of the bowels
  • Pain in the back
  • Grayish or greenish appearance of the skin on the abdominal area due to lack of blood flow to the organs
  • Constipation
  • Blood in the stool
  • Pain after consuming
  • Nausea and throwing up
  • Small soft unusual swelling on the abdominal area
  • Flank pain, specifically around the pelvis

Causes of Spigelian Hernia

The instant cause of all hernias is a weakness or hole in the wall or tissue that holds the organ in place. Spigelian hernia is no various. It is caused by a weakness in the stomach wall which results in a protrusion of the stomach organs into the stomach muscles. The weakness in the wall is triggered by different factors as described below:

  • Chronic coughing, vomiting, and sneezing — These cause continuous and repeated contractions of a lot of body muscles. This pressure on the stomach walls can deteriorate them, leading to spigelian hernia.
  • Obesity — Too much fat in the body may be lodged on stomach walls. Despite their strength, they might be unable to bear the weight, and ultimately deteriorate or even collapse in the cases of extreme obesity.
  • Pressure full physical activities and exercise — lifting of very heavy things may develop up pressure in the stomach area, leading to weakness of the stomach wall
  • Constipation — during defecation, constipated people may require to exert more pressure to pass bowels. This pressure harms the abdominal wall, especially when constipation is frequent.
  • Post-surgery infection — After an operation on the abdomen, the abdominal wall in some cases get infected and as a result compromised.
  • Heavy labor — women who give birth naturally typically exert a lot of force in the ‘pushing’ process. This pressure on the abdominal area could lead to a hernia.
  • Hereditary problems — Some individuals may acquire hernia, particularly in families with a recognized reoccurrence.
  • Congenital flaw — Spigelian hernia might be an outcome of improper development of the stomach wall prior to birth
  • Injuries to the abdomen — Sometimes, when people get physically injured on the abdominal area, the stomach wall receives some injury that slowly damage it.
  • Ascites — This is a condition where the liver stops working usually or appropriately, and there is a fluid build-up in the abdomen. These fluids develop pressure against the abdominal wall and eventually result in the hernia.
  • Multiple pregnancies — Multiparous women have been discovered to have a focal tenderness and or a mass along the linea semilunaris, which results to the spigelian hernia, strangulation of the intestines and bowel constriction.


Once spigelian hernia is thought by a physician, the following tests might be performed to identify it:

  • CT scan
  • Ultrasound
  • MRI
  • Ultrasonography

These tests assist show any irregularities in the spigelian line, which can help spot presence of the hernia. They likewise show its position and size.

One can deal with a hernia if it is not painful and does not position a risk to the health or other body organs, and life normally. However, when it comes to spigelian hernia, surgery is carried out to fix the weak point or hole on the stomach wall or remove it and enhance the damaged part with surgical mesh.

There are 2 types of surgeries for spigelian hernia: laparoscopic surgery and open surgery.

Laparoscopic surgery includes making a little cut and using a small tube and electronic camera to see and guide the medical professional to the affected part. The doctor then repair work the damaged part utilizing surgical mesh.

Open surgery includes making a larger incision on the abdominal area. The doctor has the ability to directly view and treat the hernia as deemed essential.

Laparoscopic surgery is more suitable as it has fewer problems and takes a shorter time to heal.

Different surgical approaches used consist of endoscopic, overall additional peritoneal repair work, standard, and trans stomach preperitoneal repair work.

Is a Spigelian Hernia Dangerous for Humans?

Yes, spigelian hernia is very dangerous, specifically when left untreated. It can lead to problem such as failure to pass bowels, strangulation of the intestinal tracts and absence of blood flow. In the long run, it will most likely lead to death. It is therefore encouraged to seek treatment as quick as possible.

Can a Spigelian Hernia recover itself?

While other moderate hernias particularly those that do not cause any pain can ultimately heal by themselves, spigelian hernia does not. In truth, it will get worse and become more hazardous to the other organs. For that reason immediate treatment is needed.


Spigelian hernia is a life-threatening hernia that can happen in all people. It typically happens in people in between 50-70 years, a lot of frequently in women. It must be dealt with right away when detected as more hold-up might present a danger to other organs in the abdomen, and the body at big.

The best method to prevent this condition is to take correct care of the body to prevent self-imposed hernias. You must exercise regularly and eat well to prevent obesity. At the very same time, you ought to prevent straining the body needlessly, for circumstances, by doing laborious exercise and lifting things that are too heavy. In case of any extreme injuries on the abdomen, you ought to go to a physician to have your abdominal area examined for any damage on the stomach wall, tissues, and organs.

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/// About Reyus Mammadli (article's author)

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