Large spigelian hernia: A case report

Introduction: Spigelian hernia is a rare variety of ventral abdominal hernia accounting for less than 2% of all abdominal hernias. Preoperative diagnosis is usually difficult and patients may present with intestinal obstruction. Treatment involves patient optimization and repair of the hernia. The latter is achieved either by open or laparoscopic technique with or without mesh. Outcome is usually excellent. Case Report: We report an unusually large spigelian hernia (20x30 cm) with an obvious ventral swelling in a 79-year-old female with malnutrition and uncontrolled diabetes mellitus. There was no associated intestinal obstruction. At operation, contents of the sac included viable small bowel, omentum, part of transverse colon, lower stomach, cecum and vermiform appendix. She was stabilized, had an open repair without mesh and was followed-up for eight months without signs of recurrence or other complications. Conclusion: Spigelian hernia is rare and preoperative diagnosis difficult in the majority of cases. Occasionally, like in this case, an obvious ventral swelling was present making diagnosis easier. Repair of the hernia was done by open technique without use of mesh due to the narrow defect on the abdominal wall. (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 6 No. 5, May 2015. ISSN – [0976-3198] Int J Case Rep Images 2015;6(5):321–324. www.ijcasereportsandimages.com Eze et al. 321 CASE REPORT OPEN ACCESS Large spigelian hernia: A case report Linus Eze, Kenneth Agu, Stephen Edino