A CASE REPORT OF INCARCERATED SPIGELIAN HERNIA

Abstract

Spigelian hernia is considered an uncommon spontaneous hernia of the abdominal wall. We report a case of Spigelian hernia with incarcerated small bowel and greater omentum. A 63-year-old woman was admitted to the hospital because of a right lower quadrant mass and pain. The abdominal findings showed a 15×10cm sized tender mass. CT scan of the abdomen showed the mass lateral to the linea semilunaris and contained loops of small bowel. The palient was diagnosed as having a Spigelian hernia with incarcerated small bowel and underwent an emergency surgical repair. We found herniated small bowel and greater omentum under the linea semilunaris. The hernia orifice was 2×2cm in size and was closed with interrupted suture. The patient was discharged foon the hospital 10 days later. There has been no recurrence as of 13 months after the operation. Spigelian hernia presents difficulty in presperative diagnosis because of its rarity, nonspecific symptoms and only a limited knowledge of this disease. We should consider this disease as a probable differential diagnosis for patients with an abdominal mass and pain. Liberal the most use of abdominal sonography and CT scan may allow to make the preoperative diagnosis.