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Case Reports
. 2019 Nov 8:20:1643-1647.
doi: 10.12659/AJCR.917104.

An Unusual Case of Left Spigelian Hernia Containing Part of a Fibroid Uterus and the Left Adnexa in a 66-Year-Old Woman

Gregory Nicolas  1 , Nancy Emmanuel  2 , Charlotte Charbel  3 , Adnan Awdeh  4 , Brian Bitar  3 , Salam S Abourafeh  4 , Madeleine Farah  3 , Leya Daher  5 , Abdul Aziz Mhanna  6 , George Khoury  4
Affiliations
Case Reports

An Unusual Case of Left Spigelian Hernia Containing Part of a Fibroid Uterus and the Left Adnexa in a 66-Year-Old Woman

Gregory Nicolas et al. Am J Case Rep. .

Abstract

BACKGROUND Spigelian hernia, or lateral ventral hernia, is rare and represents between 0.1-2% of all hernias of the abdominal wall. The presentation is variable, and the diagnosis may be challenging. This report is of an unusual case of Spigelian hernia that contained part of a fibroid uterus and the left adnexa. CASE REPORT A 66-year-old woman presented with an abdominal wall mass in the left lower quadrant. On physical examination, a provisional diagnosis of ventral hernia was made. Abdominal computed tomography (CT) imaging showed an unusual Spigelian hernia that contained part of a fibroid uterus and the left adnexa. Treatment using laparoscopic hysterectomy, left salpingo-oophorectomy, and hernia repair was successfully performed jointly by a general surgeon and a gynecologist. CONCLUSIONS To the best of our knowledge, the is the first reported case of Spigelian hernia that contained part of the uterus and the left adnexa.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1
Axial abdominal computed tomography (CT) images of a 66-year-old woman with a left Spigelian hernia containing part of the fibroid uterus and the left adnexa. Axial abdominal CT images with intravenous (IV) and oral (PO) contrast shows cranial to caudal images (A–C). Opacified bowel loops and calcified uterine fibroids are present within the large left lateral ventral hernia that has a wide hernia neck (A, B). The uterine fundus is shown extending from its normal pelvic location into the hernia sac (C).
Figure 2
Figure 2
Coronal and sagittal abdominal computed tomography (CT) images of a 66-year-old woman with a left Spigelian hernia containing part of the fibroid uterus and the left adnexa. Coronal (A, B) and sagittal (C) abdominal CT images with intravenous (IV) and oral (PO) contrast shows the significantly enlarged uterine fundus within the large left lateral hernia sac, showing multiple fibroids, some of which are calcified, occupying the entire anterolateral aspect of the hernia.
See this image and copyright information in PMC

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