HERNIA OF SEMILUNAR LINE (SPIGELIAN HERNIA) – A SURGICAL RARITY, NOT MERELY A PSYCHOSOMATIC DISORDER

Abstract

A Spigelian hernia occurs through a slit-like defect in the anterior abdominal wall lateral to the rectus abdominis muscle at the semilunar line in the lower quadrant of the abdomen where the posterior sheath is deficient. Due to atypical, vague, and widespread signs and symptomology, the diagnosis is always a challenging issue misleading for surgeons. Thus, a logical and high sense of suspicion is the need of the hour for diagnosing it at the early possible time, with the most common location of the lump being in the semilunar line. Once diagnosed, management is operative or else complications such as incarceration and strangulation are not uncommon. Surgical management may be conventional open or minimally invasive laparoscopic depending on the availability of expertise. We present a case of a Spigelian hernia in a lady who presented with intermittent pain in the left side of the lower abdomen for the past 8 years and was being treated symptomatically at various hospitals after being diagnosed with psychosomatic pain. She was diagnosed at our center and managed by laparoscopic mesh repair.