<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2307-0420</journal-id>
<journal-title><![CDATA[Cirugía paraguaya]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Cir. Parag.]]></abbrev-journal-title>
<issn>2307-0420</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Cirugía]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2307-04202017000200033</article-id>
<article-id pub-id-type="doi">10.18004/sopaci.agosto.33-36</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[HERNIA DE SPIEGEL NO COMPLICADA, ABORDAJE LAPAROSCOPICO]]></article-title>
<article-title xml:lang="en"><![CDATA[SPIGELIAN HERNIA. LAPAROSCOPIC APPROACH]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Herrera]]></surname>
<given-names><![CDATA[Hector]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sanabria]]></surname>
<given-names><![CDATA[Romina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Llano]]></surname>
<given-names><![CDATA[Emanuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pedrozo]]></surname>
<given-names><![CDATA[Analia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Nacional de Itaugua  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Regional de Encarnación  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Regional de Encarnación  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2017</year>
</pub-date>
<volume>41</volume>
<numero>2</numero>
<fpage>33</fpage>
<lpage>36</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2307-04202017000200033&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2307-04202017000200033&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2307-04202017000200033&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La hernia de Spiegel (HS) es una protrusión del saco peritoneal, órgano o grasa preperitoneal a través de la aponeurosis spigeliana, sea congénita o adquirida. Su incidencia varíaentre 0.12-2% de las hernias de la pared abdominal, se presenta generalmente entre los 50 y 60 años. El tratamiento es quirúrgico, y se puede realizar mediante un abordaje convencional o laparoscópico. Con las técnicas laparoscópicas se observa un bajo índice de recidivas.  Caso clínico:  Se presenta el caso de una mujer de 37 años con la presencia de una pequeña tumoración con aumento de volumen progresivo en la zona lateral de la pared abdominal de 2 meses de evolución. . A la exploración física anillo papable en la región pararrectal derecha, con una tumoración que se hace evidente con no maniobras de Valsava. Se practicó una tomografía computada en la cual se observó una hernia de Spiegel. La reparación de dicha hernia se realizó con malla, exitosamente por vía laparoscópica. Fue dada de alta al día siguiente.  Discusión:  La hernia de Spiegel es una entidad rara. Su presentación clínica es variada y, por lo tanto, hay que tener alta sospecha diagnóstica al revisar al paciente. Debido a lo poco frecuente de estas hernias y a la dificultad en el diagnóstico, consideramos que la cirugía laparoscópica tiene un rol importante en el diagnóstico y tratamiento.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[SUMMARY Spiegel hernia (SH) is a protrusion of the peritoneal sac, organ or preperitoneal fat through the Spigelianaponeurosis, either congenital or acquired. Its incidence is between 0.12-2% of abdominal wall hernias, usually present between 50 and 60 years old. The treatment is surgical and can be performed using a conventional or laparoscopic approach. A low relapse rate is observed with laparoscopics techniques.  Case report:  The case of a 37 years old woman with the presence of a small tumor with progressive increase in the right lateral area of &#8203;&#8203;the abdominal wall and it has 2 months of evolution. When performing a physical examenin the palpablke ring in the right pararrectal region, a tumor is shown without the need of performingtheValsalva manouvers. A computed tomography (CT) was performed in which a Spiegel hernia was observed. The repair of this hernia was done with a mesh, successfully by laparoscopic approach. She was discharged the next day.  Discussion: The Spiegel hernia is an uncomnmon entity. Its clinical presentation is varied and, therefore, it is necessary to have a high diagnostic suspicion when reviewing the patient. Due to the lack of infrequency of these hernias and the difficultyof diagnosis, we consider that laparoscopic surgery plays an important role in diagnosis and treatment.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Spiegel]]></kwd>
<kwd lng="es"><![CDATA[hernia]]></kwd>
<kwd lng="es"><![CDATA[laparoscopia.]]></kwd>
<kwd lng="en"><![CDATA[Spiegel]]></kwd>
<kwd lng="en"><![CDATA[hernia]]></kwd>
<kwd lng="en"><![CDATA[laparoscopy.]]></kwd>
</kwd-group>
</article-meta>
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