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Case Report: Bilateral Spigelian Hernia With Meckel's diverticulum.

Younis Mohamed1, Ahmed Hussein2, Baber Chaudhary3

  • 1General Surgery, NHS Wales Betsi Cadwaladr University Health Board, Bangor, Wales, LL572LH, UK.

F1000Research
|December 9, 2024
PubMed
Summary

This case report details a rare instance of bilateral Spigelian hernias and Meckel's diverticulum in a 72-year-old female. The management involved surgical repair of the obstructed right Spigelian hernia and the left Spigelian hernia.

Keywords:
#acute abdomen#bilateral spigelian hernia#emergency exploration#meckel´s diverticulum#spigelian hernia

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Area of Science:

  • Abdominal Surgery
  • Gastroenterology
  • Hernia Repair

Background:

  • Spigelian hernia is a rare ventral hernia (0.1%-2% incidence).
  • Bilateral Spigelian hernias are exceptionally uncommon.
  • Concurrent Meckel's diverticulum adds complexity to diagnosis and management.

Observation:

  • A 72-year-old female presented with acute abdominal pain and a palpable mass.
  • CT scan revealed an obstructed right Spigelian hernia and a left Spigelian hernia.
  • A non-complicated Meckel's diverticulum was also identified.

Findings:

  • Emergency laparotomy confirmed a viable, obstructed right Spigelian hernia, a left Spigelian hernia, and Meckel's diverticulum.
  • The right hernia was repaired with intraperitoneal sublay mesh; the left with primary repair.
  • No bowel resection was performed for the Meckel's diverticulum to avoid mesh contamination.

Implications:

  • This case highlights the diagnostic challenge of coexisting Spigelian hernias and Meckel's diverticulum.
  • Prompt surgical intervention is crucial for obstructed Spigelian hernias.
  • Careful surgical planning is necessary to manage multiple abdominal pathologies and prevent complications like mesh infection.