Spigelian hernia: a complication of laparoscopic cholecystectomy

Spigelian hernia is a rare abdominal wall hernia. It constitutes about 0.12% of all abdominal wall herniae; the peak occurrence being between the ages of 40-70 years with a male to female ratio of 1:1.18. Owing to the rarity of the disease, lack of physician experience and absence of typical hernia-like symptoms, it is a fairly difficult condition to diagnose. There is a 20% incidence of strangulation reported in the literature. The elective treatment of a Spigelian hernia is surgical: open or laparoscopic. The latter is preferred due to reduced mortality, shorter hospital stay, better cosmetic result and perhaps a lower recurrence rate. Reported here is a case of Spigelian hernia that presented to our institution, a level 1 trauma centre, as a complication of laparoscopic abdominal surgery. (Hong Kong j.emerg.med. 2010;17:388-391)