Unusual disappearing abdominal bump: spigelian hernia

Abstract

Spigelian hernia is a rare surgical entity. The presentation is nonspecific, and the diagnosis is evasive if a high index of suspicion is not maintained, more so in obese patients. Contrast enhanced computed tomography (CECT) is the imaging modality of choice. Ultrasound is less specific with high false negative rate especially in obese patients. Though these hernias are managed by both open and laparoscopic approaches, the optimal mode of management is still controversial. We present a case of spigelian hernia and discuss its diagnosis and management strategies.

Figure 1. Clinical photograph of the patient.

Figure 2. (A) Axial section (B) Sagittal section of computed tomography scan of abdomen with oral contrast. White arrow depicts the left sided hernia sac protruding through the transverses abdominis, internal oblique, and contained within external oblique muscles.