rare types of hernia
Hernia in the lumbar region, protruding through weak places of lumbar region, the so called lumbar triangles:
-lower known as Petit’s triangle located between the free margin of external oblique muscle, posteriorly by the latissimus dorsi and inferiorly by the iliac crest
-upper known as Grynfeltt’s triangle, located between the quadratus lumborum muscle, twelfth rib, and internal oblique muscle.
This is a type of incisional hernia that occurs at the site of the stoma, where to bulge out, the integrity of abdominal wall is disturbed.
Named after the Flemish anatomist Adriaan van der Spieghel, who described the semilunar line of abdominal wall, coinciding with the external rectus abdominios muscle. Namely there, at the navel level and several fingers lower, appears this rare hernia. Only 744 cases are reported by literature till 2006. This hernia type is very difficult for diagnosis, especially when it is with small size, and because it is rare, normally it is missed at the exam by non-specialist. Laparoscopic plastics is the method of treatment of Spigelian hernia.
Place of occurance of the Spigelian hernia
A hiatal hernia occurs when a part of stomach pushes upward into thoracic cavity through the natural opening of diaphragm through which esophagus passes.In this part of stomach, which is in the thoracic cavity over diaphragm, is obtained a zone of elevated intra-cavity pressure, which strongly reduces the tonus of the lower esophageal sphincter and most often favours reflux of gastric content to esophagus, and from there is the bigger frequency of the episodes of GERD (gastroesophageal reflux disease). Hiatal hernia may have different sizes. When the herniated part of stomach is big, it may compress the heart and provoke rhythm disorders, due to which patients with hiatal hernia often go to cardiologist, without having any cardiologic problem.
Especially dramatic is the clinical picture in entrapment, when operation by emergency is necessary. Laparoscopic fundoplication by Nissen is the method of choice in the treatment of hiatal hernia and GERD.
rare types of hernia