A Spigelian hernia protrudes through the Spigelian fascia, which is located at the lateral edge of the rectus abdominis. It most commonly occurs at which level?

• A At the level of the umbilicus
• B Above the arcuate line near the costal margin
• C At the level of the anterior superior iliac spine
• D At the junction of the semilunar line and the semicircular (arcuate) line of Douglas ✓

Explanation

Spigelian hernias most commonly occur at the intersection of the semilunar line (lateral border of rectus) and the semicircular line (arcuate line of Douglas, below which the posterior rectus sheath is absent). At this level, the aponeurosis is widest and structurally weakest. Because the hernia is interparietal (beneath the external oblique), it may not be visually obvious — diagnosis is often by CT or ultrasound.

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.