Journal of Ultrasound in Medicine, Vol 16, Issue 3 183-187, Copyright © 1997 by American Institute of Ultrasound in Medicine
Spigelian hernia: diagnosis by high-resolution real-time sonography
M. M. Mufid, M. M. Abu-Yousef, M. E. Kakish, L. F. Urdaneta and A. S. Al-Jurf
Department of Radiology, The University of Iowa College of Medicine, Iowa City, USA.
The purpose of this study was to demonstrate the role of high-resolution
real-time sonography in the diagnosis of spigelian hernias. The sonographic
findings in three patients, two of whom had surgical confirmation, are
presented. We also discuss and demonstrate the anatomic and pathologic
factors that predispose to these hernias. In all three cases, real-time
high-resolution sonography was very helpful in providing detailed images of
the abdominal wall defect, the hernial sac and contents, and the
relationship of the contents to the spigelian fascia and the rectus,
external oblique, and internal oblique muscles. The role of the Valsalva
and other provocative maneuvers in demonstrating the "in and out" sliding
movement of the contents of the hernia also is discussed. Although the
number of cases in our study is small, we think that this modality may be
the most effective means for establishing this diagnosis, especially in
cases with equivocal clinical findings.
