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Spigelian hernia: CT findings and clinical relevance

Abdominal Imaging volume 38, pages 260–264 (2013)Cite this article

Abstract

Objective

The purpose of our study was to evaluate the clinical relevance of preoperative CT in distinguishing between the two subtypes of spigelian hernia (SH).

Materials and methods

We reviewed retrospectively the CT images of 35 patients. The patients were divided into two groups on the basis of the SH subtype: interstitial SH group (n = 15) and subcutaneous SH group (n = 20). Clinical characteristics of patients and CT findings were analyzed. Bowel ischemia on surgery was also noted.

Results

Sixteen right hernias and 19 left hernias were observed. Fifteen interstitial SH (43%) and 20 subcutaneous SH (57%) were found. No type of content showed a statistically significant association with one or other subtype of SH. Nine of the 26 patients presenting with SH with SB content showed signs of SBO on CT. Closed-loop SBO on CT was present in 5 of the 26 patients with SB content. An interstitial SH was observed in all of these 5 patients (p = 0.039). Surgery was performed on 10 patients. Bowel ischemia was found on surgery in 4 patients and showed no statistically significant association with a particular subtype of SH (p = 0.6).

Conclusion

Our study shows the importance of performing CT in SH. CT provides the diagnosis of SH, shows SH content, and demonstrates the presence of SBO or closed-loop SBO. Moreover, the distinction between the two subtypes of SH on CT appears to be of clinical relevance since closed-loop SBO is statistically associated with interstitial SH and the optimal surgical approach may differ.

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Affiliations

  1. Service d’Imagerie Digestive et Génito-urinaire, CHU Besançon, Hôpital Jean Minjoz, 3 bvd Fleming, 25030, Besançon, France

    Mathieu Martin, Nicolas Badet, Sebastien Aubry & Eric Delabrousse

  2. Service de Chirurgie Digestive, Besançon, France

    Brice Paquette

  3. Centre d’Investigation Clinique (Inserm CIT 808), CHU Besançon, Hôpital Jean Minjoz, 3 Bvd Fleming, 25030, Besançon, France

    Frances Sheppard

  4. Laboratoire de Nanomédecine, Imagerie et Thérapeutique (EA 4662), Université de Franche-Comté, 1 rue Claude Goudimel, 25030, Besançon, France

    Eric Delabrousse

Authors
  1. Mathieu Martin
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  2. Brice Paquette
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  3. Nicolas Badet
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  4. Frances Sheppard
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  5. Sebastien Aubry
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  6. Eric Delabrousse
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Correspondence to Eric Delabrousse.

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Martin, M., Paquette, B., Badet, N. et al. Spigelian hernia: CT findings and clinical relevance. Abdom Imaging 38, 260–264 (2013). https://doi.org/10.1007/s00261-012-9889-z

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Keywords

  • Abdominal wall hernia
  • Spigelian hernia
  • Computed tomography