WordNet
- rupture in smooth muscle tissue through which a bodily structure protrudes (同)herniation
PrepTutorEJDIC
- ヘルニア,脱腸
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/10/12 23:54:10」(JST)
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| Spigelian hernia |
| Classification and external resources |
|
Transverse CT image of the abdomen in a patient with a Spigelian hernia (arrow).
|
| ICD-10 |
K43.9 |
| ICD-9 |
553.29 |
A Spigelian hernia (or lateral ventral hernia) is a hernia through the spigelian fascia, which is the aponeurotic layer between the rectus abdominis muscle medially, and the semilunar line laterally. These hernias almost always develop at or below the linea arcuata, probably because of the lack of posterior rectus sheath. These are generally interparietal hernias, meaning that they do not lie below the subcutaneous fat but penetrate between the muscles of the abdominal wall; therefore, there is often no notable swelling.
Spigelian hernias are usually small and therefore risk of strangulation is high. Most occur on the right side. (4th–7th decade of life). Compared to other types of hernias they are rare.[1]
Contents
- 1 Symptoms and diagnosis
- 2 Treatment
- 3 Eponym
- 4 Raveenthiran Syndrome
- 5 References
- 6 External links
Symptoms and diagnosis
Patients typically present with either an intermittent mass, localized pain, or signs of bowel obstruction.[1] Ultrasonography or a CT scan can establish the diagnosis, although CT scan provides the greatest sensitivity and specificity.[2]
Treatment
These hernias should be repaired because of the high risk of strangulation;[3] fortunately, surgery is straightforward, with only larger defects requiring a mesh prosthesis. Varied Spigelian hernia mesh repair techniques have been described, although evidence suggests laparoscopy results in less morbidity and shorter hospitalization compared with open procedures. Mesh-free laparoscopic suture repair is feasible and safe. This novel uncomplicated approach to small Spigelian hernias combines the benefits of laparoscopic localization, reduction, and closure without the morbidity and cost associated with foreign material.[2]
Eponym
Adriaan van den Spiegel, a surgeon-anatomist born in Brussels, described this hernia. The first publication was in 1645, twenty years after Spiegel's death.
Raveenthiran Syndrome
Raveenthiran described a new syndrome in which spigelian hernia and cryptorchidism (undescended testis) occur together (Ref: Raveenthiran V. Congenital Spigelian hernia with cryptorchidism: probably a new syndrome. Hernia. 2005 Dec;9(4):378-80. Epub 2005 Mar 22. PubMed PMID: 15782280.)
References
- ^ a b Larson DW, Farley DR (2002). "Spigelian hernias: repair and outcome for 81 patients". World journal of surgery 26 (10): 1277–81. doi:10.1007/s00268-002-6605-0. PMID 12205553.
- ^ a b Bittner JG, Edwards MA, Shah MB, MacFadyen BV, Mellinger JD (August 2008). "Mesh-free laparoscopic spigelian hernia repair". Am Surg 74 (8): 713–20; discussion 720. PMID 18705572.
- ^ Vos DI, Scheltinga MR (2004). "Incidence and outcome of surgical repair of spigelian hernia". The British journal of surgery 91 (5): 640–4. doi:10.1002/bjs.4524. PMID 15122618.
External links
- Adriaan van den Spiegel at Who Named It?
UpToDate Contents
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- 1. 成人における腹壁ヘルニアの概要 overview of abdominal wall hernias in adults
- 2. 慢性腹壁痛 chronic abdominal wall pain
English Journal
- Spigelian hernia: CT findings and clinical relevance.
- Martin M, Paquette B, Badet N, Sheppard F, Aubry S, Delabrousse E.SourceService d'Imagerie Digestive et Génito-urinaire, CHU Besançon, Hôpital Jean Minjoz, 3 bvd Fleming, 25030, Besançon, France.
- Abdominal imaging.Abdom Imaging.2012 Apr 3. [Epub ahead of print]
- OBJECTIVE: The purpose of our study was to evaluate the clinical relevance of preoperative CT in distinguishing between the two subtypes of spigelian hernia (SH).MATERIALS AND METHODS: We reviewed retrospectively the CT images of 35 patients. The patients were divided into two groups on the basis of
- PMID 22476335
- Spigelian hernia following laparoscopy.
- Kamel A, Abdallah N, El-Sandabesee D.SourceDepartment of Obstetrics and Gynaecology, Princess Alexandra Hospital, Harlow, UK. kevinkamel@hotmail.com
- Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.J Obstet Gynaecol.2012 Apr;32(3):310-1.
- PMID 22369416
Japanese Journal
- Laparoscopically Guided Repair of Spigelian Hernia with a VentralexTM Hernia Patch: Report of a Case (Case Report)
- Taro Sakamoto,Takeyuki Misawa,Katsuhiko Yanaga
- Jikeikai medical journal 60(3), 39-41, 2013-09-10
- NAID 120005347616
- 中村 威,島田 理子,千葉 斉一,有澤 淑人,橋本 光正
- 日本消化器内視鏡学会雑誌 55(4), 1484-1487, 2013
- Spigelヘルニアは比較的まれな腹壁ヘルニアである．今回，われわれは腹腔鏡で修復し得たSpigelヘルニアの1例を経験したので報告する．症例は82歳の女性．嘔気，嘔吐を主訴に当院受診した．イレウス像を呈し，CTでSpigelヘルニア嵌頓と診断した．イレウスチューブを挿入した上で手術を施行した．腹腔鏡下手術でヘルニア門を単純閉鎖して修復し得た．術後経過は良好で術後5日目に退院した．
- NAID 130003375283
- 腹腔鏡補助下手術を施行した Spigel ヘルニアによる腸管皮膚瘻の1例
- 前田 恒宏,吹上 理,藤田 洋一,佐々木 政一
- 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 73(8), 2143-2147, 2012-08-25
- NAID 10031123779
Related Links
- An example of a very rare abdominal wall hernia in the lower-mid abdomen. Our Facebook page: http://www.facebook.com/NTHRA Visit our Facebook page to start a...
- 1. World J Surg. 1989 Sep-Oct;13(5):573-80. Spigelian hernia. Spangen L. The diagnosis of spigelian hernia presents greater difficulties than its treatment. The clinical presentation varies, depending on the contents of the hernial sac ...
Related Pictures
★リンクテーブル★
[★]
- 英
- lateral ventral hernia
- 同
- 半月状線ヘルニア hernia of linea semilunaris、スピーゲルヘルニア spigelian hernia
- 関
- 腹壁ヘルニア
[★]
- 英
- spigelian hernia
- 関
- 側腹壁ヘルニア