Presentation
Rule out recurring nephrolithiasis.
Patient Data
No given history, but obvious subcutaneous postoperative scarring in the left lower quadrant of the abdomen.
Changes in keeping with a ureterocystoneostomy on the left side with an indwelling double J.
A 3 mm kidney stone is seen on the left side.
Three years later, a hernia in the left lower quadrant has developed with herniation of the small bowel between the rectus abdominis and internal oblique muscles and the external oblique muscle. This is in keeping with a Spigelian hernia. No signs of incarceration.
Three small kidney stones are seen on the left side.
Case Discussion
Spigelian hernias are a type of abdominal wall hernia in which there is herniation between the abdominal wall muscles along the semilunar line. They can be congenital or acquired, as in this case.
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