Spigelian hernia in the right upper abdominal wall: a case report

Spigelian hernia (SH) is rare and constitutes less than 2% of all hernias. It is reported that more than 90% of SHs lie in the "Spigelian belt", but SH in the upper abdominal wall is extremely uncommon. Here, we report a case of SH in the right upper quadrant of abdomen. A 38-year-old fema...

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Bibliographic Details
Published in:BMC surgery 2018-11, Vol.18 (1), p.109-109, Article 109
Main Authors: Ye, Zhou, Wang, Mo-Jin, Bai, Li-Fen, Zhuang, Han-Xiang, Zhuang, Wen
Format: Article
Language:English
Subjects:
Abdomen
Abdominal surgery
Abdominal wall
Abdominal Wall - diagnostic imaging
Abdominal Wall - surgery
Adult
Case Report
Case reports
Computed tomography
Defects
Female
Hernia
Hernia, Ventral - diagnostic imaging
Hernia, Ventral - surgery
Hernias
Humans
Ileum
Imprisonment
Laparoscopy
Medical imaging
Medical personnel
Muscles
Pain
Sheaths
Small intestine
Spigelian hernia
Spontaneous
Strangulation
Surgeons
Surgery
Tomography, X-Ray Computed
Trauma
Ultrasonic imaging
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Summary:Spigelian hernia (SH) is rare and constitutes less than 2% of all hernias. It is reported that more than 90% of SHs lie in the "Spigelian belt", but SH in the upper abdominal wall is extremely uncommon. Here, we report a case of SH in the right upper quadrant of abdomen. A 38-year-old female was admitted to hospital with complaints of abdominal pain and right upper quadrant mass for 10 days. Contrast-enhanced computed tomography (CECT) of abdomen revealed the dilated small intestine between the swelling ventral muscles in the right upper abdominal wall which suggested a ventral hernia. The surgeons considered it was a spontaneous hernia because there was no history of surgery or trauma in the upper abdomen. About two hours later, the patient underwent emergency surgery. According to laparotomy, a diagnosis of SH with ileum herniation in the right upper abdominal wall was confirmed. The necrotic ileum segment was resected. Meanwhile the abdominal wall defect was repaired by suturing the internal oblique and transverse muscles to the rectus sheath. The patient had a favorable outcome for 1 year without recurrence. A mass and pain in the upper abdominal wall may suggest an atypical SH. SH occurring in the upper abdominal wall is a rare condition with possibility of dire outcome if not managed early.
ISSN:1471-2482
1471-2482
DOI:10.1186/s12893-018-0449-5