Abstract
A 65-year-old man visited our hospital complaining of a 4×4cm soft and round mass in the right lower quadrant of the abdomen. Abdominal CT and MRI examinations disclosed an abdominal wall tumor originating from the abdominal wall muscle. In Jauary 1999, the mass became slightly enlarged, but disappeared with the patient in the supine position. A second abdominal CT examination revealed a Spigelian hernia that passed through the Spigelian fascia from the abdominal cavity. Operative findings confirmed a Spigelian hernia. The hernia sac with preperitoneal fat had penetrated the external oblique aponeurosis through the Spigelian fascia. The transverse oblique and internal oblique aponeurosis were sutured to the lateral side and anterior sheath of the rectus abdominis muscle in layers. Posterior repair of the spermatic cord using Marlex mesh was performed. His postoperative course was uneventful and he is now symptom free.
