Spigelian Hernia

A Spigelian hernia, also called a lateral ventral hernia or hernia of the semilunar line, occurs when tissue pushes through a weak spot in the abdominal muscles along the Spigelian fascia. Though rare, this type of hernia can be dangerous if left untreated, since it has a high risk of complications like obstruction or strangulation.

On this page, we’ll cover what a Spigelian hernia is, what causes it, symptoms to watch for, how it is diagnosed, and treatment options.

What Is a Spigelian Hernia?

The Spigelian fascia is a layer of tissue that runs along the outer edge of the rectus abdominis muscle. A Spigelian hernia develops when a defect in this fascia allows abdominal tissue or intestine to protrude through, typically in the lower abdomen.

Unlike some other hernia types, Spigelian hernias are often not visible as an obvious bulge, which can make them harder to detect. Because of their narrow openings, they are more likely to trap intestinal tissue, making early diagnosis and treatment critical.

Causes and Risk Factors

Spigelian hernias can develop due to congenital weakness (present at birth) or acquired muscle weakness later in life.

Common contributing factors include:

• Chronic increased abdominal pressure (from obesity, pregnancy, or persistent coughing/straining)
• Abdominal trauma or injury
• Weakening of muscles due to aging
• Heavy lifting or repetitive strain

At higher risk: Men over age 50 are more commonly affected.

Symptoms of Spigelian Hernia

Symptoms may vary, but typical signs include:

• A lump or bulge in the abdominal wall, often more noticeable when standing or straining
• Pain or tenderness in the abdomen, especially with physical activity
• Changes in bowel habits, such as constipation or difficulty passing stool
• Blood in stool (a sign of complications)
• Nausea or vomiting

Seek emergency care immediately if you experience:

• Severe, sudden abdominal pain
• A tender bulge that does not go away
• Persistent nausea, vomiting, or constipation

These may indicate a strangulated hernia, a life-threatening condition where blood supply to the intestine is cut off.

Diagnosis

Because Spigelian hernias are less obvious than other types, doctors may use several methods to confirm the diagnosis:

• Physical exam – including palpation of the abdominal wall and Valsalva maneuver (bearing down or coughing).
• Ultrasound – first-line imaging for soft tissue hernias.
• CT scan – provides cross-sectional images for more complex or unclear cases.
• MRI – sometimes used for detailed visualization of tissues.

Treatment Options

Spigelian hernias do not heal on their own. Surgery is the only effective treatment.

Surgical Approaches

• Open Repair Surgery – The surgeon makes an incision over the hernia, pushes tissue back into place, and reinforces the muscle wall with stitches or synthetic mesh. Recovery typically takes 4–6 weeks.
• Laparoscopic Repair – A minimally invasive procedure using several small incisions and a laparoscope (tiny camera). Offers quicker recovery, less pain, and smaller scars compared to open repair.

Because of the high risk of incarceration and strangulation, scheduling surgery promptly is strongly recommended.

Complications if Untreated

If not treated, Spigelian hernias can lead to:

• Incarceration – trapped tissue that cannot be pushed back in
• Obstruction – blockage in the intestine, leading to pain and digestive issues
• Strangulation – loss of blood supply to trapped tissue, causing tissue death and requiring emergency surgery

Expert Care at Hernia Innovations

At Hernia Innovations, our board-certified surgeons specialize in diagnosing and treating rare and complex hernia types, including Spigelian hernias. Using the latest laparoscopic and robotic-assisted techniques, we provide safer procedures, shorter recovery times, and long-term results.

Call us today at (925) 940-1025 or request a consultation online.