Spigelian Hernia In Sydney – Causes, Symptoms & Specialist Assessment
What Is A Spigelian Hernia?
A Spigelian hernia is a rare type of abdominal wall hernia that occurs along the outer edge of the rectus (six-pack) muscles, where the abdominal wall layers meet. This area is known as the Spigelian fascia.
Unlike many other hernias, a Spigelian hernia may not produce a clearly visible lump because it can develop between muscle layers. For this reason, it is sometimes referred to as a “hidden hernia.”
Patients with a Spigelian hernia in Sydney often seek specialist assessment when they experience persistent side abdominal pain without an obvious bulge.
Where Does A Spigelian Hernia Occur?
Spigelian hernias typically occur:
Along the lower outer abdominal wall
Just below the level of the belly button
Lateral to the rectus abdominis muscle
They are less common than inguinal, umbilical, or incisional hernias but may carry a higher risk of complications due to the narrow neck of the defect.
What Causes A Spigelian Hernia?
Spigelian hernias develop due to weakness in the abdominal wall combined with increased abdominal pressure.
Contributing factors may include:
• Previous abdominal surgery
• Obesity
• Chronic coughing
• Heavy lifting
• Pregnancy
• Age-related muscle weakness
In some cases, no clear trigger is identified.
Symptoms Of A Spigelian Hernia
Symptoms can be subtle and may include:
• Localised pain on the side of the abdomen
• Tenderness without a visible lump
• Pain that worsens with straining, coughing, or lifting
• Intermittent swelling
Because the hernia may sit between muscle layers, diagnosis can be more challenging than other abdominal wall hernias.
Why Early Assessment Is Important
Spigelian hernias have a relatively higher risk of incarceration or strangulation compared with some other hernia types.
This occurs when:
The hernia contents become trapped
Blood supply becomes compromised
Severe pain and obstruction develop
Symptoms such as sudden severe pain, nausea, vomiting, or a firm tender swelling require urgent hospital assessment.
Early specialist evaluation allows planned surgical repair and reduces the risk of emergency surgery.
How Is A Spigelian Hernia Diagnosed?
Diagnosis begins with clinical examination.
Because these hernias may be difficult to feel, imaging is often required:
• Ultrasound
• CT scan (commonly used)
• MRI (in selected cases)
Imaging helps confirm the diagnosis and assess the size and contents of the hernia.
Treatment Of Spigelian Hernia
Spigelian hernias do not resolve on their own.
Surgical repair is generally recommended due to the risk of complications.
Repair may be performed using:
• Laparoscopic (keyhole) hernia repair
• Open hernia repair
The most appropriate technique depends on:
• Hernia size
• Patient anatomy
• Previous surgery
• Overall health
For more information about surgical options, see our Hernia Surgery (Hernia Repair) in Sydney page.
Book a Consultation With Dr David Joseph
If you are experiencing persistent abdominal wall pain or have been diagnosed with a Spigelian hernia, early specialist assessment is recommended.
Call 02 9565 5514 or complete the form below.
Related Upper Gastrointestinal Conditions
Spigelian hernias may coexist with other abdominal conditions requiring specialist management.
• Inguinal Hernia – groin hernia
• Umbilical Hernia – hernia at the belly button
• Incisional / Ventral Hernia – hernia at previous surgical sites
• Gallbladder Disease – may also cause upper abdominal pain
Comprehensive assessment ensures all contributing conditions are appropriately managed.
Spigelian Hernia FAQs
What is a Spigelian hernia?
A Spigelian hernia is a rare abdominal wall hernia that develops along the outer edge of the rectus muscle, within the Spigelian fascia. Unlike other hernias, it may not produce a visible lump because it can form between muscle layers.
How is a Spigelian hernia different from other hernias?
Spigelian hernias occur on the side of the abdominal wall rather than in the groin or belly button. They are often harder to detect clinically and may require imaging such as a CT scan for accurate diagnosis.
Is a Spigelian hernia dangerous?
Spigelian hernias carry a higher risk of incarceration or strangulation compared with some other hernia types. Because the defect is often narrow, trapped tissue can lose its blood supply. Early specialist assessment is recommended.
What symptoms does a Spigelian hernia cause?
Symptoms may include:
• Localised abdominal pain
• Tenderness on the side of the abdomen
• Pain that worsens with lifting or coughing
• Intermittent swelling
Some patients have pain without a clearly visible lump.
How is a Spigelian hernia diagnosed?
Diagnosis may require imaging. Ultrasound can help, but CT scan is commonly used because it clearly shows the abdominal wall layers and confirms the defect.
Does a Spigelian hernia require surgery?
Spigelian hernias do not heal on their own. Surgical repair is usually recommended due to the risk of complications. Repair may be performed laparoscopically (keyhole) or via an open approach, depending on the individual case.
How urgent is surgery for a Spigelian hernia?
If symptoms are stable, surgery can be planned electively. However, sudden severe pain, nausea, vomiting, or a firm tender swelling requires urgent hospital assessment, as this may indicate strangulation.
Do you have questions about Hernia Surgery or would like to schedule an appointment with Dr Joseph? Please call 02 9565 5514 to book your consultation.
