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Spigelian hernia and pitfalls of postoperative anticoagulation
  1. Xiaotong Cheryl Tan1,
  2. Sunny Nalavenkata2,
  3. Michael Yunaev3
  1. 1ACT Health, Canberra, ACT, Australia
  2. 2NSW Health, North Sydney, New South Wales, Australia
  3. 3Department of General Surgery, Kalgoorlie Regional Hospital, Kalgoorlie, Western Australia, Australia
  1. Correspondence to Dr Xiaotong Cheryl Tan, chen.xiaotong90{at}


Spigelian hernias are a rare lateral ventral abdominal hernia that carry a high risk of strangulation due to their smaller sizes, and require surgical intervention. In more complex cases involving an anticoagulated patient, perioperative management of anticoagulation must be monitored and reviewed to avoid potential pitfalls. We present an 81-year-old woman who presented with right groin pain, and was requiring warfarin anticoagulation due to her cardiac history. The spigelian hernia was diagnosed and reduced laparoscopically, and the defect was repaired and reinforced by mesh. However, the patient suffered from catastrophic complications postoperatively related to her anticoagulation management. Spigelian hernias require surgical interventions. However, in an anticoagulated patient with significant comorbidities, perioperative anticoagulation needs to be closely monitored to balance the risk of thromboembolic disease with acceptable postoperative bleeding risks.

  • general surgery
  • drug therapy related to surgery

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  • Contributors XCT: contributed in literature search and review as well as wrote and edited the report. SN: collated the initial data as well as reviewed and edited the report. MY: reviewed and edited the report.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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