Answer for BIR CoW 08 Feb 2026
Spigelian Hernia
Findings
Evidence of defect of size 2.7x2.4cm noted in right linea semilunaris, with herniation of small bowel loop as content. The hernial sac lies between rectus abdominis muscle medially and oblique abdominal muscles laterally. Laterally, the sac is limited by intact right external oblique muscle and does not extend beyond it. - Features suggestive of Interparietal type of spigelian hernia
Discussion
The Spigelian hernia is a type of lateral ventral hernia. The hernial orifice of a Spigelian hernia is located in the Spigelian fascia, that is, between the lateral border of the rectus abdominis muscle and the semilunar line, through the transversus abdominis aponeurosis, close to the level of the arcuate line. The majority of Spigelian hernias are found in a transverse band lying between 0 and 6 centimeters cranial to a line running between both anterior superior iliac spines,referred to as the Spigelian hernia belt. Most Spigelian hernias occur in the lower abdomen where the posterior sheath is deficient. There are two types of Spigelian hernia : Interparietal: External oblique aponeurosis remains intact and is pushed forward by the herniated contents. Subcutaneous: External oblique aponeurosis is penetrated by the herniated contents.
Findings
Evidence of defect of size 2.7x2.4cm noted in right linea semilunaris, with herniation of small bowel loop as content. The hernial sac lies between rectus abdominis muscle medially and oblique abdominal muscles laterally. Laterally, the sac is limited by intact right external oblique muscle and does not extend beyond it. - Features suggestive of Interparietal type of spigelian hernia
Discussion
The Spigelian hernia is a type of lateral ventral hernia. The hernial orifice of a Spigelian hernia is located in the Spigelian fascia, that is, between the lateral border of the rectus abdominis muscle and the semilunar line, through the transversus abdominis aponeurosis, close to the level of the arcuate line. The majority of Spigelian hernias are found in a transverse band lying between 0 and 6 centimeters cranial to a line running between both anterior superior iliac spines,referred to as the Spigelian hernia belt. Most Spigelian hernias occur in the lower abdomen where the posterior sheath is deficient. There are two types of Spigelian hernia : Interparietal: External oblique aponeurosis remains intact and is pushed forward by the herniated contents. Subcutaneous: External oblique aponeurosis is penetrated by the herniated contents.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!