Presentation
Acute abdominal pain and vomiting for 2 days.
Patient Data
Dilated central bowel loops are suggestive of small bowel obstruction. No pneumoperitoneum.
Contrast CT images of abdomen reveals acute small bowel obstruction due to incarcerated right lower anterior abdominal wall Spigelian hernia. No perforation. No gallstone ileus. No bowel ischemia.
Another left lower anterior abdominal Spigelian hernia containing large bowel loops is noted without any bowel obstruction.
Cholelithiasis. Colonic diverticulosis.
Bilateral lower lobe consolidations.
Case Discussion
Spigelian hernias are lateral ventral abdominal wall hernias which can result in herniation of abdominal contents between the muscle layers. Irreducible hernias may result in bowel obstruction and ischemia.
The patient underwent timely surgery with reduction of hernia and resolved bowel obstruction.
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