From the Research
Interparietal hernias are extremely rare, accounting for less than 1% of all abdominal wall hernias, with an estimated incidence of approximately 0.01-0.05% of all hernias encountered in clinical practice. These hernias occur when the hernia sac is located between the layers of the abdominal wall, most commonly between the internal oblique and external oblique muscles. The incidence of interparietal hernias is not well-established due to their rarity, but they are most frequently found in the inguinal region (Spigelian hernias being a subtype), though they can also occur at other anatomical sites, such as the lumbar region 1, 2. Males are affected slightly more often than females, with a peak incidence in the fourth to seventh decades of life. Predisposing factors include previous abdominal surgery, trauma, obesity, pregnancy, and conditions that increase intra-abdominal pressure 3, 4.
Due to their rarity and often subtle clinical presentation, interparietal hernias are frequently misdiagnosed or discovered incidentally during imaging studies or surgery for other conditions. The diagnosis requires a high index of suspicion and is best confirmed with CT imaging 1, 5. Prompt surgical repair is recommended upon diagnosis to prevent complications such as incarceration or strangulation. Laparoscopic repair is a feasible and effective treatment option for interparietal hernias, as demonstrated in recent case reports 1, 5.
Some key points to consider in the diagnosis and management of interparietal hernias include:
- High index of suspicion is required for diagnosis
- CT imaging is the best diagnostic tool
- Prompt surgical repair is recommended to prevent complications
- Laparoscopic repair is a feasible and effective treatment option
- Predisposing factors include previous abdominal surgery, trauma, obesity, pregnancy, and conditions that increase intra-abdominal pressure. The most recent and highest quality study on this topic is 5, which highlights the importance of prompt surgical repair and the feasibility of laparoscopic repair for interparietal hernias.