Spigelian Hernias: Rare but Serious—Causes, Symptoms & Treatment

A Spigelian hernia is a rare type of abdominal wall hernia that often goes unnoticed because it develops beneath layers of muscle. Although uncommon, it can cause significant health risks if left untreated. Understanding the causes, symptoms, and treatment options is key to early detection and safe recovery.

What Is a Spigelian Hernia?

A Spigelian hernia occurs along the Spigelian fascia, a thin layer of tissue in the abdominal wall. Unlike more common hernias that push through defined openings, this type pushes through weak points between muscle layers, making it harder to spot.

• Typically develops near the rectus abdominis (the “six-pack” muscle).
• Often causes pain or discomfort mistaken for other abdominal issues.
• More common in people over 50 and in women, but can affect anyone.

Although rare, Spigelian hernias account for about 1–2% of all abdominal wall hernias.

Causes and Risk Factors

A Spigelian hernia develops when weakness in the fascia allows internal tissue or organs to protrude. Contributing factors include:

• Chronic strain: heavy lifting, persistent coughing, or constipation.
• Obesity: extra pressure weakens abdominal tissue over time.
• Past abdominal surgeries: scars or weakened muscle can create weak points.
• Pregnancy: repeated stretching of the abdominal wall increases risk.
• Aging: natural muscle weakening, especially over age 50.

Symptoms of Spigelian Hernias

Unlike other hernias, Spigelian hernias often lack a visible bulge. Instead, patients may notice:

• Localized pain or tenderness in the lower abdomen.
• Discomfort that worsens with lifting, coughing, or straining.
• A feeling of fullness or pressure in the abdomen.

Severe symptoms such as nausea, vomiting, or inability to pass stool may signal an incarcerated or strangulated hernia—a medical emergency.

Diagnosis

Because they are hidden beneath muscle, diagnosis often requires imaging:

• Physical exam – may suggest a hernia but often inconclusive.
• Ultrasound – first-line imaging, effective for detecting hidden hernias.
• CT scan or MRI – used when ultrasound is unclear or complications are suspected.

Treatment Options

Spigelian hernias almost always require surgical repair, as non-surgical management carries too high a risk.

Open Repair Surgery

• Surgeon makes a direct incision, pushes hernia back, and reinforces with stitches or mesh.
• Longer recovery but effective.

Laparoscopic Surgery

• Small incisions and a camera allow minimally invasive repair.
• Less pain, faster recovery, and shorter hospital stay.

Mesh Reinforcement

• Standard in both methods, significantly reduces recurrence rates.

Your surgeon will recommend the best approach depending on hernia size, location, and your medical history.

Complications and Risks

Spigelian hernias carry a high risk of incarceration or strangulation:

• Incarceration: trapped tissue causes pain and obstruction.
• Strangulation: blood supply is cut off, leading to tissue death—life-threatening.

Other risks: infection, recurrence (rare with mesh), or postoperative pain. Prompt treatment reduces these risks dramatically.

Prognosis and Recovery

With timely surgery, prognosis is excellent. Most patients resume normal activity within 4–6 weeks, sooner with laparoscopic repair.

Tips for long-term success:

• Maintain a healthy weight.
• Avoid unnecessary strain on the abdomen.
• Follow surgeon’s post-op care instructions.

Prevention Tips

While not all hernias can be prevented, you can lower your risk by:

• Maintaining a healthy BMI.
• Practicing safe lifting techniques.
• Treating chronic cough or constipation.
• Engaging in core-strengthening exercises (once cleared by a doctor).

Conclusion

Though rare, Spigelian hernias can be dangerous if untreated. Early detection and proper surgical repair lead to excellent outcomes.

At Hernia Innovations, our specialists provide advanced hernia care with a focus on patient safety and recovery. If you’re experiencing symptoms, don’t delay—schedule a consultation today.