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2012 ; 12
(50
): 269-75
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Sonographic imaging of Spigelian hernias
#MMPMID26675533
Smereczy?ski A
; Ko?aczyk K
; Lubi?ski J
; Bojko S
; Ga?dy?ska M
; Bernatowicz E
J Ultrason
2012[Sep]; 12
(50
): 269-75
PMID26675533
show ga
THE AIM OF THE WORK: was to present clinical material referring to rarely
occurring abdominal cavity hernias in semilunar line - Spigelian hernias
diagnosed with the help of ultrasound. MATERIAL AND METHODS: In the period from
1995 to 2001 785 anterior abdominal wall hernias were diagnosed including 11
Spigelian hernias (1.4%) diagnosed in 10 patients (7 women and 3 men) aged from
38 to 65 years old (average age 48). Eight patients complained of spastic pain in
abdomen, in 5 of them it was accompanied by bloating and sometimes loud
peristalsis. All the patients had been observing the mentioned symptoms from 2 to
5 years. Each of them had had colonoscopy and abdominal cavity ultrasound
examination performed, some of them even three times. In 3 women with uterine
fibroid the uterus was removed which did not eliminate the symptoms. The
ultrasound examination of the abdominal integument was performed mainly with the
use of linear transducers of the frequency of 7-12 MHz; in obese patients also
convex transducers were used (3,5-6 MHz). Each examination of abdominal
integument included the assessment of the following areas: linea alba from
xiphoid process to pubic symphysis including umbilicus, both semilunar lines from
costal margins to pubic bones, and also inguinal areas. Moreover, all types of
postoperative scars were examined. Each hernia was assessed in terms of size (the
greatest dimension), hernia sac contents, width of the ring and reducibility
under the compression of the transducer. Moreover, cough test and Valsalva's
maneuver were performed. Generally, the examination was performed in a standing
position. RESULTS: In 9 patients hernias were localized unilaterally, in one
patient bilaterally. In 7 cases the hernia sac contained small bowel, in 2 cases
the preperitoneal and omental fat, and in 2 cases preperitoneal fat only. Eight
patients presenting with clinical symptoms underwent operative repair.
CONCLUSION: Ultrasound examination is beneficial in confirming the diagnosis of
Spigelian hernias especially in terms of proper, therapeutic decision-making.
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