A Spigelian hernia characteristically occurs at which anatomical site?

• A Through the linea alba above the umbilicus
• B Through a defect in the obturator foramen
• C At the intersection of the transversalis fascia and inferior epigastric vessels
• D At the level of the arcuate line (semicircular line of Douglas), lateral to the rectus at the semilunar line ✓

Explanation

A Spigelian hernia (lateral ventral hernia) occurs through the spigelian fascia — the aponeurotic zone between the lateral edge of the rectus abdominis (linea semilunaris) and the lateral border of the posterior rectus sheath. It most commonly occurs just below and lateral to the arcuate line (semicircular line of Douglas), where the posterior layer of the rectus sheath becomes deficient, creating a locus minoris resistentiae. These hernias are often interparietal (between layers), making them difficult to detect clinically; ultrasound or CT is frequently required.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.