An: 2012, Nr.3, Articol Nr. 12
STRANGULATED SPIEGEL HERNIA ASSOCIATED WITH FEMORAL HERNIA
V. Ardeleanu - Universitatea “Dunărea de Jos” Galaţi, Facultatea de Medicină şi Farmacie, Spitalul Clinic de Urgenţă “Sf. Apostol Andrei”, Clinica 1 Chirurgie, Galaţi, România
S. Chicoş - Universitatea “Dunărea de Jos” Galaţi, Facultatea de Medicină şi Farmacie
STRANGULATED SPIEGEL HERNIA ASSOCIATED WITH FEMORAL HERNIA (Abstract): Spiegel hernias occur at the level of semilunar line that start from the top of 9th rib to 2cm laterally of the pubis spine and corresponds in depth to the separation limit between the muscular part and the anterior aponeurosis of the transversal abdominal muscle, the occurence of this type of hernias is 0 2% of the total number of diagnosed and operated hernias. More often met in the fifth and the sixth decade of life and are more frequently met on the right side of the body. The present paper presents the case of an obese 79 year old patient who was admitted with medium abdominal pain, on the right inguinal side, followed by the obstruction in the intestinal transit for gas and faeces and meteorism. On palpation the presence of a pseudotumoural is felt, 12/8cm average, with the longitudinal axis oriented descendently and laterally oblique, painful, irreducible, that presents with impulsion and expansion when coughing, apparently at the level of the right superficial inguinal orifice, which was under the skin. Echographically, the diagnosis of right inguinal hernia with intestinal loop slided in the hernial bag, is confirmed. Intraoperatory, it has been found the presence of a strangled spiegel hernia,with the ileal loop slided in the hernia bag. The patient also had a right femoral hernia, with no complications. The hernia is rarely exteriorated under the skin, most frequently remaining between the flat muscles of the abdomen. The treatment for this type of hernias is always surgical, either by classical methods or by caelioscopic methods, with usually good results, rarely with recidivation. The echograph was not useful in this case, although along with the CT scans they represent the main methods of diagnosis for this type of hernias.
Key words: HERNIA, OCLUSION, SPIEGEL LINE