Spigelian Hernia In Sydney – Causes, Symptoms & Specialist Assessment

A Spigelian hernia is a less common type of abdominal wall hernia that may cause localised pain or a subtle lump along the side of the abdomen.

Because it can be difficult to detect, symptoms are sometimes vague — making specialist assessment important for diagnosis and treatment.

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.

Because these hernias can develop between muscle layers, they may not produce a clearly visible lump and can be difficult to detect. For this reason, they are sometimes referred to as a “hidden hernia.”

Although rare, Spigelian hernias carry a relatively higher risk of incarceration or strangulation, which is why surgical repair is usually recommended once diagnosed.

Patients with a Spigelian hernia in Sydney often seek specialist assessment when they experience persistent side abdominal pain with or without an obvious bulge.

Spigelian hernias are one of several types of abdominal wall hernias. Learn more about Hernia in Sydney – Causes, Symptoms & Specialist Assessment.

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. The narrow defect increases the likelihood of bowel becoming trapped.

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.

Spigelian Hernia Symptoms

Symptoms of a Spigelian hernia can be subtle and may occur without a visible lump. Common symptoms 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.

Experiencing spigelian hernia symptoms? Call 02 9565 5514 to book a consultation with Dr David Joseph. Urgent appointments are available.

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 careful clinical examination by an experienced upper gastrointestinal surgeon.

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 of a Spigelian hernia in Sydney 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 Hernia 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

• Abdominal Wall Hernias – including incisional and ventral hernia.

Other conditions that may be related to hernia repair:

• Obesity and Weight-Related Conditions – increased abdominal pressure may contribute to hernia formation.

• Gallbladder Disease – may also cause upper abdominal pain

Comprehensive assessment ensures all contributing conditions are appropriately managed.

Learn more about Hernia in Sydney for an overview of all abdominal wall hernia types.

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.