Spigelian hernia protrudes through the Spigelian aponeurosis (linea semilunaris) at the lateral edge of the rectus abdominis. What makes this hernia particularly dangerous despite often being small?
- A High recurrence rate after repair
- B Close proximity to the inferior epigastric vessels
- C It is typically interparietal — concealed between muscle layers — causing delayed diagnosis with high incarceration risk ✓
- D Association with chronic liver disease and ascites
Correct answer: C. It is typically interparietal — concealed between muscle layers — causing delayed diagnosis with high incarceration risk
Explanation
Spigelian hernias are characteristically interparietal: the hernia sac passes through the aponeurosis but remains beneath the intact external oblique, making it impalpable on examination and invisible externally. This leads to delayed diagnosis; by the time symptoms occur, the hernia may already be incarcerated or strangulated. CT or ultrasound is required for diagnosis. Despite being small defects, the dense, narrow neck predisposes to strangulation.
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.