Hernia: Spigelian hernia: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hernia: Spigelian hernia

Sample item

A 60-year-old woman has localised pain and a small tender swelling lateral to the rectus sheath, below the umbilicus. It is visible only on straining and the external oblique aponeurosis is intact. Which hernia is it?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Spigelian hernia

A Spigelian hernia protrudes through the linea semilunaris, most often near the arcuate line below the umbilicus. It is usually interparietal, lying beneath an intact external oblique aponeurosis, so it is easily missed clinically, and ultrasound or CT confirms it. Repair is advised because the neck is narrow and strangulation is common.

Option by option

  • A. Spigelian hernia (correct)

    Correct. A defect at the linea semilunaris near the arcuate line is characteristic.

  • B. Direct inguinal hernia

    Direct inguinal hernia occurs through Hesselbach's triangle above the inguinal ligament.

  • C. Obturator hernia

    Obturator hernia presents with medial thigh pain and obstruction, not an abdominal wall swelling.

  • D. Epigastric hernia

    Epigastric hernia occurs in the midline linea alba above the umbilicus.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Spigelian hernia. A Spigelian hernia protrudes through the linea semilunaris, most often near the arcuate line below the umbilicus.

Why is "Direct inguinal hernia" not the answer?

Direct inguinal hernia occurs through Hesselbach's triangle above the inguinal ligament.

Why is "Obturator hernia" not the answer?

Obturator hernia presents with medial thigh pain and obstruction, not an abdominal wall swelling.

Why is "Epigastric hernia" not the answer?

Epigastric hernia occurs in the midline linea alba above the umbilicus.

What concept does this question test?

It tests Hernia: Spigelian hernia in General Surgery. It is usually interparietal, lying beneath an intact external oblique aponeurosis, so it is easily missed clinically, and ultrasound or CT confirms it. Repair is advised because the neck is narrow and strangulation is common.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hernia: Spigelian hernia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.