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Related Experiment Video

Updated: Jun 15, 2025

Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair

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Perforated appendicitis within a spigelian hernia.

Sarah Kate Whitehouse¹, Sara Izwan², Maseelan Naidoo²

¹General Surgery, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia sarah.whitehouse5@health.qld.gov.au.

BMJ Case Reports

|August 23, 2024

Summary

A case study details a spigelian hernia in a nonagenarian woman presenting with acute abdominal pain. Surgical repair was performed, highlighting a rare presentation of this abdominal wall defect.

Keywords:

General surgery Surgery

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Area of Science:

Gastroenterology
Surgical Case Reports
Abdominal Wall Surgery

Background:

Spigelian hernias are rare abdominal wall defects, often diagnosed late.
Presentation with acute pain and bowel compromise is uncommon, particularly in the elderly.

Observation:

A nonagenarian woman presented with acute right spigelian hernia pain, fever, and hypotension.
CT imaging revealed incarcerated small and large bowel with significant fat stranding within the hernia.

Findings:

The patient underwent open appendicectomy and suture repair of the spigelian hernia.
Literature review indicates suture repair is predominant, with mixed open and laparoscopic approaches.

Implications:

This case underscores the importance of considering spigelian hernias in elderly patients with acute abdominal symptoms.
Timely surgical intervention is crucial for managing incarcerated spigelian hernias to prevent complications.