2025 Volume 45 Issue 4 Pages 466-469
A 67-year-old woman presented to us with a history of having been aware of a bulge in her right lower abdomen for several years. Two weeks earlier, she had presented to our emergency department with enlargement of the bulge and pain. A 12-cm-sized bulge was observed in the right lower abdomen, with erythema of the overlying skin, marked tenderness, and rippling. A contrast-enhanced CT of the abdomen revealed an 8-cm-sized internal heterogeneous low-absorption area adjacent to protruding ileocecum from the outer edge of the right rectus abdominis muscle, which was determined to be an abscess. Abscess drainage was performed, and after 10 days, the drain was removed after confirming the disappearance of the abscess cavity, and the patient was operated upon by an anterior approach. When the hernia sac was opened, adhesion of the cecum was observed. Since the same area was thought to be the cause of the abscess, we performed a cecectomy and also an appendectomy in consideration of the possibility of appendicitis. The patient was discharged on the 10th day after the operation. We report a case of Spigelian hernia with abscess formation around the prolapsed ileocecum.
