You may feel localized abdominal pain or notice an occasional bulge, yet the source can be surprisingly difficult to find. That is often the challenge with a Spigelian hernia, a rare abdominal wall defect that can remain partly hidden beneath layers of muscle.
Spigelian hernias deserve careful evaluation because their anatomy can allow abdominal tissue or intestine to become trapped. NYC Hernia in New York, NY, is led by Dr. Brian Jacob, MD, FACS, a surgeon who has devoted much of his career to hernia care and complex abdominal conditions. He has performed thousands of hernia procedures and holds a faculty appointment as a Clinical Professor of Surgery at the Icahn School of Medicine at Mount Sinai.
What Is a Spigelian Hernia?
What Does a Spigelian Hernia Feel Like?
Symptoms vary based on the hernia’s size and contents. Some patients notice a lump along the lower side of the abdomen, particularly when standing, coughing, or straining.
Other possible symptoms include:
- Localized abdominal pain
- Tenderness along the side of the abdomen
- A bulge that appears and disappears
- Pressure during exercise or lifting
- Pain without an obvious external lump
Because these symptoms can resemble other abdominal conditions, imaging may be helpful when the diagnosis is uncertain.
How Is a Spigelian Hernia Diagnosed?
Dr. Jacob evaluates the location of the discomfort or bulge and checks whether it changes with standing, coughing, or tightening the abdominal muscles.
Ultrasound can help evaluate some suspected Spigelian hernias. CT imaging may provide a clearer picture of the abdominal wall, hernia defect, and tissue contained within it when the physical examination is inconclusive.
A careful evaluation is important because an occult Spigelian hernia can produce symptoms even without a prominent bulge.
Does a Spigelian Hernia Need Surgery?
Surgical repair is generally recommended after a Spigelian hernia has been diagnosed. These hernias have relatively narrow defects and are associated with a higher risk of incarceration than many common abdominal wall hernias.
Incarceration occurs when tissue becomes trapped and cannot easily return to the abdominal cavity. If trapped intestine loses its blood supply, strangulation can occur, and emergency surgery may be necessary.
Repair can be performed through an open, laparoscopic, or robotic approach depending on the hernia and the patient’s circumstances. Mesh is commonly considered to reinforce the abdominal wall, although the exact repair depends on factors such as defect size and surgical findings.
What Can I Expect From Recovery?
Recovery varies depending on the operation performed and whether the repair was elective or urgent. Many patients are encouraged to begin gentle walking early while temporarily avoiding strenuous activity and heavy lifting.
Dr. Jacob provides instructions regarding activity, incision care, and return to normal routines based on the extent of the repair.
Why Choose NYC Hernia for Spigelian Hernia in New York, NY?
Because a Spigelian hernia can be difficult to detect, experience with unusual hernia anatomy matters from the initial evaluation through surgical planning. Dr. Jacob’s career has centered heavily on hernia repair, abdominal pain, and groin pain, including complex cases that may require an individualized operative strategy.
He founded the International Hernia Collaboration and has written extensively about hernia repair and surgical education. His academic work includes peer-reviewed publications and co-editing The SAGES Manual of Hernia Repair and The SAGES Manual of Groin Pain. He has also served in leadership roles with SAGES and the Americas Hernia Society.
Address a Spigelian Hernia Before Complications Develop
A Spigelian hernia can be easy to overlook, but its location and risk of trapping abdominal contents make proper diagnosis and treatment important. Surgical repair can close the defect and reinforce the weakened area before an elective problem becomes an emergency.
Book a consultation with Dr. Brian Jacob at NYC Hernia in New York, NY, to discuss Spigelian hernia repair. Call 212-879-6677 to schedule an appointment online (opens in new tab).
