Spigelian hernia in the right lower abdomen: A case report

Abstract

Spigelian hernia is a rare entity, with an incidence of approximately 2% of all hernias. Adriann Spieghel first described it in 1645. It is a congenital or acquired defect in the Spigelian aponeurosis - an area between the semilunar line and lateral border of the rectus muscle. It is challenging to diagnose Spigelian hernia preoperatively as the sac is usually located between the muscle layers of the abdominal wall. Computed tomography or ultrasound of the abdomen is often the preferred diagnostic modality for confirming the diagnosis. Surgery should be performed immediately after the diagnosis, either by open or laparoscopic repair because the rate of incarceration is very high in the case of Spigelian hernia. We report a female patient presenting with pain in the right lower abdomen and a palpable swelling, and later diagnosed as a case of Spigelian hernia. The patient underwent open-mesh repair and recovered well without any complication or recurrence at a 6-month follow-up.

Keywords

• arcuate line
• semilunar line
• spigelian aponeurosis
• spigelian hernia