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Spigelian hernia in the right upper abdominal wall: a case report.
Zhou Ye1, Mo-Jin Wang2, Li-Fen Bai2
1Department of Digestive Diseases, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, China.
BMC Surgery
|November 29, 2018
Summary
A rare Spigelian hernia (SH) in the upper abdomen presented as pain and a mass. Early diagnosis and surgical repair led to a favorable outcome, highlighting the importance of considering atypical SH presentations.
Area of Science:
- Abdominal Surgery
- Hernia Repair
- Gastrointestinal Surgery
Background:
- Spigelian hernia (SH) is a rare condition, accounting for less than 2% of all hernias.
- Most SHs occur in the "Spigelian belt," with upper abdominal wall SH being exceptionally uncommon.
- This case highlights an atypical presentation of SH in the right upper quadrant.
Observation:
- A 38-year-old female presented with abdominal pain and a right upper quadrant mass.
- Contrast-enhanced computed tomography (CECT) suggested a ventral hernia with small intestine herniation.
- The hernia was deemed spontaneous due to no prior abdominal surgery or trauma.
Findings:
- Laparotomy confirmed a Spigelian hernia with ileum herniation in the right upper abdominal wall.
- Surgical intervention involved resection of necrotic ileum and repair of the abdominal wall defect.
- The defect was closed by suturing the internal oblique and transverse muscles to the rectus sheath.
Implications:
- Upper abdominal masses and pain may indicate an atypical Spigelian hernia.
- Prompt diagnosis and management of upper abdominal SH are crucial to prevent severe complications.
- This case underscores the need for vigilance in diagnosing rare hernia presentations.
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