Spigelian hernia intermittent mass, localized pain, or signs of bowel obstruction. Ultrasonography or a CT scan can establish the diagnosis, although CT scan provides the greatest sensitivity and specificity. These hernias should be repaired because of the high risk of strangulation; surgery is straightforward, with only larger defects requiring a mesh prosthesis. Varied Spigelian hernia mesh repair techniques have been described, although evidence suggests laparoscopy results in less morbidity and shorter hospitalization compared with open procedures. Mesh-free laparoscopic suture repair is feasible and safe. This novel uncomplicated approach to small Spigelian hernias combines the benefits of laparoscopic localization, reduction, and closure without
Superior epigastric artery thoracic aorta and abdominal aorta. If the abdominal aorta develops a significant stenosis and/or blockage (as may be caused by atherosclerosis), this collateral pathway may develop sufficiently, over time, to supply blood to the lower limbs. A congenitally narrowed aorta, due to coarctation, is often associated with a significant enlargement of the internal thoracic and epigastric arteries. Superior epigastric artery In human anatomy, superior epigastric artery refers to a blood vessel that carries oxygenated blood and arises from the internal thoracic artery (referred to as the internal mammary artery in the accompanying diagram). It anastomoses with the inferior epigastric artery