Hernia de Spiegel
Paciente femenina de 43 años de edad sometida hace 3 meses a cirugías simultaneas de hernia umbilical e histerectomia total.. A partir de esos eventos comenzó a quejarse de dolor ocasional, punzante, localizado en la región de la fosa iliaca derecha,las molestias se incrementan a lo largo del día y sobre todo al estar mucho de pie, situación esta ultima que se acompaña de pequeño bultoma que protuye en la zona. El examen físico no es muy revelador a pesar de que la paciente señala con un dedo el punto exacto del problema. El examen sonografico muestra área sacular an-ecogena que representa un saco herniario peritoneal, sin contenido de asas intestinales o de otro tipo, se aprecia claramente el anillo y que el saco se introduce al través de la fascia posterior del musculo recto anterior, mide aprox 0,67 X 0,41cm. La imagen no sufre modificaciones significativas con la maniobra de Valsalva y al examinarla de pie, desaparece la imagen. Se concluye con el diagnostico de Hernia de Spiegel.
Tomado de la Revista Espanola de Enfermedades Digestivas
Rev. esp. enferm. dig. v.102 n.10 Madrid oct. 2010
La hernia de Spiegel (HS) debe su nombre al anatomista francés Adrian van Spiegel, que describió la línea semilunar por primera vez en 1645. Sin embargo fue posteriormente Klinkosch el que describió una hernia ventral lateral espontánea situada sobre la línea semilunar de Spiegel en 1764 es una variedad poco frecuente de defecto de la pared abdominal. Supone el 0,1-2% de todas las hernias abdominales.Se producen por debilidad de la aponeurosis de Spiegel o spiegeliana, localizada entre la línea semilunar y el borde externo del músculo recto.Aunque se han descrito casos relacionados con defectos musculares congénitos, la mayoría son adquiridas y se consideran factores de riesgo asociados la obesidad, la EPOC, presencia de otras hernias y los traumatismos abdominales puede ser difícil detectarlas durante la exploración pues el saco herniario queda bajo la aponeurosis del oblicuo mayor.Se presentan con más frecuencia a partir de la quinta década de la vida y con un discreto predominio femenino. No existen diferencias significativas en cuanto a su localización derecha o izquierda en la literatura, así como tampoco existen en nuestro estudio
References
Hernia de Spiegel.Nuestra experiencia y revision del la literatura
Spiegel´s Hernia
Female patient, 43 years of age under 3 months makes simultaneous umbilical hernia surgeries and a total hysterectomy. From these events began to complain of occasional sharp pain, located in the region of the right iliac fossa discomfort increases throughout the day and especially being a long-standing, latter situation that is accompanied by a small bultoma that protrudes in the area. Physical examination is not very revealing even though the patient points a finger at the exact point of the problem. The sonographic examination shows a saccular an-echogenic area representing a peritoneal hernia sac, containing no bowel or other bag, clearly shows the ring and the bag are introduced through the posterior rectus fascia anterior muscle, measures approx 0.67 X 0,41cm. The image does not undergo significant changes with the Valsalva maneuver and standing examination, the image disappears. It concludes with the diagnosis of Spiegel's hernia.
Taken from the Spanish Journal of Gastroenterology
Rev. Esp. Digestive Disease V.102 n.10 Madrid Oct. 2010
Spiegel's hernia (HS) was named after the French anatomist Adrian van Spiegel, who described the semilunar line for the first time in 1645, however, was later Klinkosch which described a spontaneous lateral ventral hernia located on the semilunar line Spiegel in 1764 is an uncommon variety of abdominal wall defect. Accounts for 0.1-2% of all hernias occur abdominal. It weakness Spiegel's fascia or spiegeliana, located between the semilunar line and the lateral border of the muscle rectum. although cases have been reported related to congenital muscular defects most are acquired and are considered risk factors for obesity, COPD, presence of other hernias and abdominal injuries can be difficult to detect during scanning because the hernia sac is under the aponeurosis of the oblique mayor. Occur more frequently from the fifth decade of life and a discrete female predominance. No significant differences in terms of left or right location in the literature, nor in our study there
Taken from the Spanish Journal of Gastroenterology
Rev. Esp. Digestive Disease V.102 n.10 Madrid Oct. 2010
Spiegel's hernia (HS) was named after the French anatomist Adrian van Spiegel, who described the semilunar line for the first time in 1645, however, was later Klinkosch which described a spontaneous lateral ventral hernia located on the semilunar line Spiegel in 1764 is an uncommon variety of abdominal wall defect. Accounts for 0.1-2% of all hernias occur abdominal. It weakness Spiegel's fascia or spiegeliana, located between the semilunar line and the lateral border of the muscle rectum. although cases have been reported related to congenital muscular defects most are acquired and are considered risk factors for obesity, COPD, presence of other hernias and abdominal injuries can be difficult to detect during scanning because the hernia sac is under the aponeurosis of the oblique mayor. Occur more frequently from the fifth decade of life and a discrete female predominance. No significant differences in terms of left or right location in the literature, nor in our study there
