Undescended Testis in Spigelian Hernia – A Report of 2 Cases and Review of the Literature

Spigelian hernias are usually seen in elderly people, generally after the age of 50. As such, they are rare in children and less than 40 cases have been reported [1] [2] [3]. Age range varies form neonatal age to adolescence [1]. Up to 15% of these were bilateral in nature and they were reported more frequently in males [1] [2] [3]. The usual contents of the hernial sac are pre-peritoneal fat, small bowel, colon or omentum [1]. A few recent reports have described the factors leading to a high incidence of cryptorchidism in such cases [2] [3].

We report 2 cases where the hernial sac contained testis, which is a rare presentation, and discuss the relevant literature.

References

• 1 Losanoff JE, Richman BW, Jones JW. Spigelian hernia in a child: case report and review of the literature.  Hernia. 2002;  6 191-193
• 2 Raveenthiran V. Congenital Spigelian hernia and cryptorchidism: a distinct clinical syndrome.  J Pediatr Surg. 2007;  42 1794-1795
• 3 Rushfeldt C, Oltmanns G, Vonen B. Spigelian-cryptorchidism syndrome: A case report and discussion of the basic elements in a possibly new congenital syndrome.  Pediatr Surg Int. 2010;  26 939-942
• 4 Silberstein PA, Kern IB, Shi EC. Congenital Spigelian hernia with cryptorchidism.  J Pediatr Surg. 1996;  31 1208-1210
• 5 Ostlie DJ, Zerella JT. Undescended testicle associated with Spigelian hernia.  J Pediatr Surg. 1998;  33 1426-1428
• 6 Al-Salem AH. Congenital Spigelian hernia and cryptorchidism: cause or coincidence?.  Pediatr Surg Int. 2000;  16 433-436
• 7 Levy G, Nagar H, Blachar A. et al . Preoperative sonographic diagnosis of incarcerated neonatal spigelian hernia containing the testis.  Pediatr Radiol. 2003;  33 407-409
• 8 Torres de Aguirre A, Cabello Laureano R, Garcia Valles C. et al . Spigelian hernia: two cases associated to cryptorchidism.  Cir Pediatr. 2005;  18 99-100
• 9 Durham MM, Ricketts RR. Congenital Spigelian hernias and cryptorchidism.  J Pediatr Surg. 2006;  41 1814-1817
• 10 Larson DW, Farley DR. Spigelian hernias: Repair and outcome for 81 patients.  World J Surgery. 2002;  26 1277-1281

Correspondence