A Spigelian hernia protrudes through the Spigelian aponeurosis. At which anatomical level does it most commonly occur?
- A Above the umbilicus at the level of the semi-lunar line
- B At the level of the McBurney's point
- C At or just below the arcuate line (Douglas's line) ✓
- D At the midpoint of the inguinal ligament
Correct answer: C. At or just below the arcuate line (Douglas's line)
Explanation
Spigelian hernias occur through defects in the Spigelian aponeurosis (the portion of the transversus aponeurosis lateral to the rectus sheath). The most common location is at or just below the arcuate line (semicircular line of Douglas), where the posterior rectus sheath is absent and the aponeurosis is widest and weakest. They are typically inter-parietal and often occult on examination.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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