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Beyond the Abdominal Wall: Appendiceal Abscess Concealed Within a Spigelian Hernia
Ioannis Katsarelas1, Alexandra Panagiotou1, Mohammad Husamieh1
1Department of General Surgery, General Hospital of Katerini, 60132 Katerini, Greece.
Reports (MDPI)
|May 27, 2026
Summary
A rare case of a perforated appendix within a Spigelian hernia highlights the diagnostic importance of Computed Tomography (CT). Early CT scans are crucial for identifying complex abdominal wall pathologies and guiding timely surgical intervention.
Area of Science:
- Abdominal Surgery
- Radiology
- Gastroenterology
Background:
- Spigelian hernias are uncommon abdominal wall defects.
- Appendix incarceration within a Spigelian hernia is exceptionally rare.
- This case involves a long-standing herniated appendix progressing to perforation and abscess.
Purpose of the Study:
- To report an unusual case of a perforated appendix within a Spigelian hernia.
- To illustrate the clinical progression to an atypical surgical emergency.
- To emphasize the diagnostic value of early Computed Tomography (CT).
Main Methods:
- Case report of a patient with a Spigelian hernia.
- Utilized Computed Tomography (CT) for diagnosis.
- Performed prompt surgical intervention and hernia repair.
Main Results:
- The patient presented with a long-standing herniated appendix that perforated.
- Abscess formation occurred secondary to the perforation.
- Early CT imaging was vital in resolving diagnostic uncertainty.
- Prompt surgery led to an uneventful recovery.
Conclusions:
- Early Computed Tomography (CT) is essential for diagnosing complex abdominal wall pathologies like incarcerated and perforated appendices.
- Timely surgical intervention and hernia repair are critical for favorable outcomes.
- This case underscores the importance of considering rare presentations of common conditions.
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