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Incarcerated Spigelian hernia mimicking obstructing colon carcinoma
R Miller1, O Lifschitz, E Mavor
1Department of Surgery A, Kaplan Medical Center, Israel and Hebrew University Jerusalem, P.O. Box 1, Rehovot 76100, Israel. rafmiller@gmail.com
Summary
Spigelian hernia, a rare ventral abdominal hernia, can cause bowel incarceration. This case highlights sigmoid colon obstruction within a Spigelian hernia sac, successfully diagnosed by CT and repaired with mesh.
Area of Science:
- Gastroenterology
- Abdominal Surgery
- Radiology
Background:
- Spigelian hernia is a rare ventral abdominal wall defect.
- Incarceration and strangulation are infrequent complications.
- Colonic obstruction is an exceptionally rare presentation.
Observation:
- A patient presented with symptoms mimicking obstructive colonic carcinoma.
- The obstruction was caused by incarcerated sigmoid colon within a Spigelian hernia.
- Contrast enema suggested a neoplastic obstruction.
Findings:
- Pre-operative diagnosis was accurately established using computed tomography (CT).
- The incarcerated sigmoid colon was successfully repaired.
- A tension-free repair using polypropylene mesh was performed.
Implications:
- CT is crucial for pre-operative diagnosis of incarcerated Spigelian hernia.
- Early diagnosis and surgical intervention prevent complications.
- Mesh repair offers a tension-free solution for Spigelian hernias.
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