S7E3 Spigelian Hernia a very rare hernia

#hernia #spigelianhernia #abdominalhernia #DrsFunFood #healthcheck101 #health-check101.com
In these videos I explain in very simple language, anatomy and physiology (working) of different organs in human body. In each season I will select an organ and will talk about most common conditions that affect that part. I will talk about why that condition happens, diagnosis, investigations, complications, treatment and outcome of that disease.
All you need to know about Spigelian hernia. These are very uncommon hernias. In my surgical career of over 30 years I have only come across three. Diagnosis of these hernias is difficult as many of them are mistaken for other diseases and even other hernias especially inguinal hernia. Treatment is not difficult but can be challenging for an inexperienced surgeon. Also watch my videos on Epigastric hernia, Umbilical hernia, inguinal hernia, femoral hernia and incisional hernia also known as surgical hernia.

[@Squarekn0t]

Just had my 20mm spigelian hernia robotically repaired on August 7th, 2023, The first surgeon I visited in February, ordered the c-scan, when I went to get the results, he said the Spigelian hernia was "not clinically relevant" along with an 18mm Gallstone near the neck. Well it was relevant to me, because I am a very active 78 year old. Whenever I did some yard work, walked around the Lowes store for 30 min, or grocery shopping , it felt like someone had parked a Volkswagen in my arcuate linea. Foot note: My younger brother (62) died in November, after 47 days in the ICU from a strangulated bowl obstruction. Your demonstration gave a clear understanding where and how these occur, and how dangerous this could become if not repaired. Some Doctors don't want to hear that you have been on Y-tube but this is an example of how a pro-active patient can save his/her life! Blessings to you!

[@healthcheck1014]

I am so happy that the surgeon took your symptoms seriously. Thank you for your kind comments Warm wishes

[@Squarekn0t]

@@healthcheck1014 TO DO- something, however small, to make others happier and better, is the highest ambition, the most elevating hope which inspire a human being. ---Avebury 1909

[@AubreyForever]

Was the C-Scan with contrast?

[@Squarekn0t]

Had to look it up, but yes it was with contrast, Dr. put in a mesh and sometimes it fells like somebody left a piece of sandpaper in there.

[@AubreyForever]

Thanks, not sure you can see one without contrast. @@Squarekn0t

[@saicharan9584]

Thank you for clear explaination !

[@Thee-_-Outlier]

Thank you doctor, a good video on this hernia for patients was missing on KZbin. Much appreciated

[@heatherk.906]

You are an excellent and careful teacher! Thank you so much for making this video. I'm glad I took the time to listen to it.

[@husseinjasim1981]

Very nice explanation... I examined a patient with similar symptoms but at a higher level on the right and waiting for CT scan of the abdomen....

[@healthcheck1014]

Thank you so much

[@juanabauza5686]

How i can get hold of you, im in Mallorca, but i Just found you, and everything you explain in right.they nearly kill me, but as i know my body,thank goodnees to you i know , it to control it. Im 61 .thank you for your videos,you did open my mind.thank a lot.

[@catherinerec3844]

Perfect explanation.

[@dr.bardosdavid]

Very helpful video, thank you.

[@moochymooo]

Thank you Dr, for such an easy to understand explanation👍. I have had many misdiagnoses over many years before finally getting the correct one by a very thorough, new GP to my area. I finally go for open Spigelian Hernia repair next week. My latest U/sound shows it now has a wide neck. I've lost count of the number of ambulance trips to hospital due to the excruciating pain of small bowel herniating into it. I sure won't miss that pain or the morphine to dull it. Wish me luck!

[@healthcheck1014]

Best of luck

[@dienivaca2473]

Can you diagnose it with ultrasound or mri

[@johannwolf1]

I developed a spigelian hernia, as pain in precisely this location (above descending colon) in my early 30s after living 6 months in a foreign country that had rather sub standard food (Ukraine 90s) compared to my California diet. Nothing bulged out but the pain felt both inside my gut and between the skin and stomach muscle wall and was quite intense. I had my sports therapist / massage guy if it was a hernia and he said no... probably because there was no bulge. I battled this pain especially flaring up when the colon was full, for the next 10 plus years never knowing what it was, changing diets, having colonoscopies suspecting all kinds of things. After moving back to California it subsided somewhat, but it was a long journey. At one point I suspected parasites and I did an intense 14 week cleanse going from raw food to juice to water and back again slowly taking herbs and psyllium bentonite clay and multiple daily enemas to clear all mucoid plaque (read Richard Anderson Cleanse and Purify thyself) ... I lost 20 lbs (from 165 to 145) and reset my metabolism. I still fast occasionally and intermittent fast daily 15 plus hours. I cannot recommend this enough. We don't need much food. In my late 40s or early 50s it finally popped out. It was a hernia all along just as I originally suspected (use your intuition more).... it rarely pops out and that is the only time it hurts, I can easily press it back in... and I'm slowly healing it completely naturally. It rarely pops out now and never hurts. Western medical doctors tend to be brainwashed quacks. The body is excellent at repairing itself if you take care of it. I have intense pain in my lumbar, most likely herniated discs for 4 years now that I am now working on healing. I'm athletic, and a surfer and have been almost handicapped by this at times. I cannot pick my cat up off the floor or bend forward. It's a challenge now to see if I can repair this and become stronger than ever. It's an interesting journey and I recommend people take charge of their own healing, learning and growing. Play with your body constantly, experiment with it, and with diet and mindset. Stretch, sing, pray do whatever connects you to your higher happier source... get lots of sleep and dream. hope this helps somebody.

[@user-kl4rt2yf1r]

I think I have a Spigellian and the lumbar pain too but I think it is a small lumbar hernia, I have multiple small Hernias, in my mid-30s so far seems like a 10 year diagnosis.

[@sahajabanoth8900]

Diaphragmatic hernia….plz make a video on it and do examinations

[@risinglarkmusic2264]

Can you comment on which method is preferred (IPOM, TEP, TAPP) and on the pros or cons of non-mesh repair (75 Y female, BMI 24.4)? Thank you.

[@healthcheck1014]

All types of repair have their pros and cons. In my opinion best option is the one that your surgeon prefers as that is the one he will get best results for you Best wishes

[@fustosgabo92]

MR scan is okay or just CT? Based on Spiegel (I always want to sit down) I had symptom for 10 months ago, but the doctors don't believe me.. Ultrasound said it was just a muscle... I dont think so i want MR to be sure about it. Big thanks for help! ❤

[@zerogen8989]

Great video. Please, tell me: What would one do if there is no pain associated (even when lifting heavy and deliberately bracing core before heavy lifts!), only vague tenderness and a sense of pressure? I have felt this lump for almost 4 years now, but as I have mentioned, there is no pain associated-at all! Couching, lifting, bracing, hiking-nothing triggers pain. The only thing I can feel is only aforementioned vague tenderness, little pressure. I can feel it more whenever I lie on my back. Strangely enough, pressing deep into it while lying on my back is quite painful.

[@healthcheck1014]

Friend Sorry for the delay in replying. In my opinion, if it’s not broke don’t fix it. Get it checked out first with an ultrasound that the lump is actually a hernia and not something like a lipoma which are harmless. If scan confirms a hernia then get treatment when it gets bigger or starts giving symptoms All the very best

[@zerogen8989]

@@healthcheck1014 What a wonderful and helpful reply. Please, accept my gratitude! Wish you all the best!

[@healthcheck1014]

@@zerogen8989 you are most welcome

[@vickieaugusteed.d.3723]

Very informative! I had this issue and it was missed 3 times by CT SCAN. Had 2 large bulges. It’s been repaired via laparoscopic surgery but the bulges are still there. Will they resolve themselves eventually or will I have to live with this huge bulge? I’m thin in the abdomen area except for the Spigelian Hernia repair area that was done with mesh.

[@healthcheck1014]

Sometimes the hernia sac can collect fluid which causes the bulge. Many of them settle, some may need aspiration with a needle

[@anmolsharma-qb1qi]

Hi sir, can this type of hernia is detected from MRI scan also as I am having a tickeling pain in left abdomen and weakness in left arm from past 2 weeks which is not going even after medications??

[@healthcheck1014]

Yes they should be able to pick it on an MRI

[@kelee4730]

Thank you! This is a wonderful explanation of spigelian hernia ! Is there any possible that CT examination missed to find out this hernia due to lay down position of patient ? Is your patient experiencing symptoms without pain but suffers from indigestion bloating and constipation? Will they feel better for a while by trying pushing back the intestines ？ Is this possible that the left side get more trouble due to over use of muscles on left during constipation and the over use of left muscle by incorrect sitting and workout pattern in a long term?

[@healthcheck1014]

Thanks for your comments friend 🙏 It is true that CT can miss a hernia if it has reduced when lying flat. Your reasoning why it is more common on the left side makes sense but I have seen so few of these hernias in my career that it is not possible for me to say for sure. Thing’s that you mentioned like constipation, abdominal exercises which increases the pressure in the abdomen can increase the risk of developing any hernia and Spigelian is no exception. Thank you again .

[@Squarekn0t]

When I went for my CT scan the tech asked me where the lump/pain was, She put a metallic "bullit" at that spot . I also had a small 2.5 umbilic hernia

[@Extman]

Can spigellian hernia be on the upper left abdomen?

[@healthcheck1014]

I have never seen one that far up

[@balamurganj6763]

Myself also diagnosed as this type of herina, bur lap surgery done, but doctor told me, their is no deflect in internalabdominalwall, and planned for open surgery after 3months, sir, kindly guide me

[@healthcheck1014]

Friend If laparoscopy did not show a defect then you do not have a hernia, I presume your surgeon suspect some other problem hence he wants to explore further, you must ask him what does he suspect

[@Bluekro1991]

Great video iv got this issue I belive iv asked my gp about it he got me to lay down on the bed and checked my stomach and said he didn't feel anything or see a bulge so can't be a hernia but like you have said in your video it doesn't tend to display a hernia . What can I say to my gp as I'm in pain it hurts to sit hurts to bend forward etc I need help and my gp in England is doing very little

[@healthcheck1014]

Request a surgical opinion, I am sure a surgeon will look into it further I wish you all the best

[@sassygirlie1167]

I've been missed for a few years and it was only when one Dr finally listened to me and I asked if hernias could come and go. 3rd emergency room trip it took and as far as I know, I was presenting with strangulation symptoms. It was only by luck sitting awkwardly it puts it back to just painful. Ct scan picked it up. Mine is right sided x

[@healthcheck1014]

@@sassygirlie1167 thank you for sharing 🙏

[@healthcheck1014]

@@sassygirlie1167 I am so glad that your persistence eventually got the correct diagnosis. Best of luck and let me know how the treatment goes ☺️

[@sassygirlie1167]

@@healthcheck1014 I will do. I hope it's not long as I keep getting episodes x

[@Chef_cameraman]

Can this particular type of hernia mimic Gynaecology issues? I have had 3 different Doctors suggest the pain i have is 1) Gynaecology, 2) Muscular. I have had chronic R) Iliac fossa pain for 2 years +. Many Diagnostic tests- Pelvic u/s Abdo U/S Bladder u/s Abdo CT Colonoscopy All results unremarkable. The pain can be incredibly painful when pushed into the area, (pain can feel like a sharp pinch or can change to a heavy type pain) the pain intensity also changes- pain can be dull and uncomfortable then other times so painful that I am unable to function properly. Also the pain location is near the appendix area but I have had an appendectomy approx 30 years ago. Could this be potentially be a Spigelian Hernia?

[@healthcheck1014]

Doctors have obviously left no stone unturned. CT would have picked up a hernia. Have they ruled out endometriosis? Do you suffer from any back problems as sometimes pain from a trapped nerve in the back can cause referred pain in the abdomen?

[@Chef_cameraman]

@@healthcheck1014 Thank you for your response. I have no back pain or back problems, and have ruled out endometriosis.

[@healthcheck1014]

@@Chef_cameraman have the doctors considered doing a diagnostic laparoscopy?

[@Chef_cameraman]

No, I haven’t been advised to have Any further investigations.

[@LoveWins1960]

I had this rare type of hernia. It was extremely painful which likely saved my life. I am 3 weeks post op. I had a bowel resection and mesh inserted. This hernia was on my right side. CT scan found the issue. There was swelling also. I am currently experiencing pain internally where the mesh is (I believe). I'm very nervous something isn't right, or that it will reoccur.

[@-myal-8691]

How successful is surgery for a Spigelian hernia? What is the complication and success rate?

[@healthcheck1014]

Hello friend Outcome of any operation depends on surgeons skill and experience. Recurrence following surgery for this condition should be no more than 5 to 10 percent. Complications can happen after any operation but should be less than 5 percent. Main complications after hernia surgery is recurrence, bleeding, infection (more common if mesh was used), wound pain (less common with keyhole) and the most serious is bowel injury which is very uncommon

[@-myal-8691]

@@healthcheck1014 Thank you for your reply. It was very helpful.

[@Squarekn0t]

I just had my 20mm Spigelian robotically removed on the 7th August. In at 7:30 back home at 10. Some belly pain but able to move around on the third day. Note try to stay away from the pain med's. They will give you bad constipation that will be worse than any other complication. I took only one 5 mg Oxy and then went to a combo of Advil and Ibuprofen. @@healthcheck1014

[@jamesham1180]

I don’t see any bulge , pain or experience any symptoms, but when I put my chin down I can feel a mild kicking sensation from left side of belly button ( just 2-3 inches). Is this a spigelian hernia?

[@healthcheck1014]

It is difficult to say friend , in the first instance you should be examined by a surgeon followed by a scan

[@XxXK9]

Can violently vomitting cause this type of hernia? Especially if the person is severely overweight (me)

[@healthcheck1014]

Friend Anything that increases the intra abdominal pressure e.g coughing, constipation, vomiting etc can increase the risk of developing a hernia

[@dienivaca2473]

So it is not possible to fix it with some kind of exercise? To close the gap between rectus abdominis and obliques? Like for example exercises for diastasis recti? Or is surgery the only option?

[@XxXK9]

It’s because I made myself throw up on purpose once after drinking, and waking up hungover. After a few days went by I had testicular pain and upper left abdominal pain. Testicular pain went away but I’m still dealing with upper left abdominal pain. And it’s been 2 months.

[@68461]

if i suspect i have one how fast should i go see a doctor?? ive had an abdominal x ray twice and an ultrasound a while ago. ive been having abdominal pain and nausea for months.. like maybe almost a year?? but they've found nothing so far- it got bad enough for me to go to med express about a month ago and they found i was pretty badly constipated- one of my medications causes that as well but- also i feel like i see and sort of feel a lump somewhat up and right of my belly button now that is visible most only when i stand up. i also feel bloated a lot. also ALSO im obese. if it's any help im also 18. my anxiety is pretty bad about this but my depression hates leaving the house + im afraid the doctors won't even listen to me cause it's so rare- but is it an emergency should i go to the er?? one of my doctor has me me an appointment for next month for a gastroenterologist should i just wait for that?? my stomach pain got pretty bad yesterday aswell but that might have been anxiety.. sorry i really just can't seem to get a clear answer anywhere online and i don't even have a primary care physician right now cause nobody will take me with all the medication im already on so I'd have to go to the er or med express again or something.. but i don't wanna if it's not necessary/i should just wait

[@healthcheck1014]

Unfortunately, we as medical professionals do become judgemental about patients with anxiety and depression. It is very sad. But these patients also get physical problems like hernia etc. there are out there who will take your symptoms seriously. Don’t give up hope 👍🏽

[@amandacampbell8075]

I have a tender spot approx 2 inches to the right of my navel and a inch or so below. No bulge, I’m not overweight, but I have a large belly in this area, so difficult to see or feel anyway. It aches and burns at times, I can sometimes feel movement, a spasm feeling, possibly from digestion , in this spot. It has flare ups, and then will just go away. If I isolate the abdominal muscle with sudden movement it will spasm into a Charlie horse like cramp and ache for days afterward. Also, when I just graze my fingers over the skin in that area it feels slightly painful, like pins and needles. I have had three c sections, last was 4 years ago. I strained my lower stomach constantly lifting my toddler. I suspect I may have this hernia. This has been going on for 6 months or so.

[@healthcheck1014]

Dear madam I agree that you should be checked for a similar hernia as they can be very difficult to feel. Reading your symptoms, they sound neuropathic in nature which could be due to a number of different reasons I wish you the very best

[@amandacampbell8075]

@@healthcheck1014 just an update. Went to gyno today and scheduled for CT. He believed he felt a defect in fascia near c section incision and suspects hernia. He also mentioned could be coming from spine if my DDD has progressed to thoracic area. So will see when CT is completed.

[@healthcheck1014]

@@amandacampbell8075 do let me know the outcome Best of luck 🤞

[@squirrellygirl1]

How hard is this to find in a morbidly obese patient with weakened abdominal muscles from multiple surgeries and hypermobile Ehlers Danlos?

[@healthcheck1014]

Very very hard

[@squirrellygirl1]

@@healthcheck1014 Do you have any suggestions for how to find a surgeon to evaluate this in the US (Wisconsin or the Midwest)? I have had several CTs and physical exams (one standing) and one surgeon and two physical therapists have felt the intermittent bulges but the imaging does not show any incarcerated herniations. However, I see irregular bulging on my CT that no one has been able to explain to me in the exact locations of Spigelian hernias, and repeat CTs when the bulging was not prominent do not have the same defect. I am exasperated and do not want to offend providers that want to help me by pushing too hard for a diagnosis of something this rare when I am not a medical provider. My weight and lipedema tissue complicate this.

[@ShivneilPratap-ManUtd]

4.45 -- 6:45

[@umarpmch21]

There is a common misconception that they protrude below the arcuate line as a result of deficiency of the posterior rectus sheath at that level but in fact the defect is almost always above the arcuate line - Bailey and Love 27th edition, page 1042

[@healthcheck1014]

Thank you Dr Umar, I am most grateful

[@balamurganj6763]

Myself a

[@noodlexyz8546]

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