GI Radiology > Hernia > External > Others

Spigelian, Grynfeltt, and Petit Hernia

Spigelian Hernias

Spigelian hernias are an uncommon hernia of the anterior abdominal wall. These hernias occur lateral to the rectus abdominis through a defect in the linea semilunaris, which is the aponeuroses of the internal oblique and transversus abdominis muscles. They typically present as bowel loops projecting laterally through the abdominal wall. Spigelian hernias may be difficult to palpate when they extend between the internal and external oblique muscles.

Spigelian hernias usually occur in patients with: (1) Increased intraabdominal pressure (heavy labor, urinary retention, COPD or gastric outlet obstruction), or (2) Multiparous women and patients with recent significant weight loss. Clinical findings include focal tenderness or a mass along the linea semilunaris. Bowel incarceration and strangulation are common.

Lumbar Hernias

Lumbar hernias occur in the superior and inferior lumbar spaces, better known as the Grynfeltt-Lesshaft and Petit Triangles. These hernias are rare in occurrance and typically seen on the left side. They are more common among men. Clinically, they present as a soft-tissue flank bulge with discomfort and/or muscle weakness. Lumbar hernias may consist of bowel, omentum, kidney, spleen, or stomach, and they are best characterized by CT.

There are two type of lumbar hernias: Grynfeltt (upper lumbar) and Petit (lower lumbar). Grynfeltt hernias occur through the superior lumbar triangle bordered by the 12th rib, internal oblique and sacrospinalis muscles. Petit hernias occur through the inferior lumbar triangle bordered by external oblique, latissimus dorsi and iliac crest.

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