Abstract
Background: Spigelian hernia best described as spontaneous lateral ventral hernia is an extremely rare type of hernia. The anatomical peculiarities and diagnostic challenges need to be understood in order to surgically mange this hernia.
 Introduction: Spigelian hernia occurs through a defect in the spigelian fascia typically lying in the spigelian zone.
 Case report: A case of a large incarcerated spigelian hernia is presented to highlight the diagnostic and anatomical peculiarities of this hernia.
 Discussion: The anatomical basis of this hernia along with clinical presentation, diagnostic modalities and treatment options is discussed.
 Conclusion: Clinical suspicion confirmed by imaging is necessary for diagnosis. Surgery is the mainstay of treatment.
Highlights
INTRODUCTIONSpigelian hernia is a protrusion of pre peritoneal fat, peritoneal sac or viscera through a defect in spigelian fascia
Spigelian hernia occurs through a defect in the spigelian fascia typically lying in the spigelian zone
Spigelian hernia is a protrusion of pre peritoneal fat, peritoneal sac or viscera through a defect in spigelian fascia
Summary
Spigelian hernia is a protrusion of pre peritoneal fat, peritoneal sac or viscera through a defect in spigelian fascia. It constitutes 0.12% of all abdominal wall hernias. The hernia is named after Adriaan van der Spieghel who discovered the semi lunar line in 1645. [1,2] Joseph Klinkosch was the first to describe spigelian hernia as a defect in the semi lunar line in 1764.[1] Since this herniation takes place into a closed space, the presentation many a times may be subtle thereby making diagnosis difficult. A case of a large incarcerated spigelian hernia is presented along with a brief review of literature to create an awareness about the anatomical basis, clinical intricacies and surgical options for managing this extremely rare and elusive type of hernia
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