Bilateral Spigelian hernia

Case contributed by Dr Sherif Maher

Presentation

Patient presented to the outpatient clinic with persistent bilateral lower quadrant swellings and pain and gave history of previous surgery for hernial repair.

Patient Data

Age: 70 years
Gender: Male
CT

Bilateral lower quadrant herniaa through the transversus abdominis aponeurosis, along the semilunar line between the rectus abdominis muscles and the lateral abdominal musculature, large on the right side and containing fat with ileal loop with one loop insinuated below the external oblique muscle, on the left side containing fat and is seen partially below the external oblique muscle. No stranding of the herniated fat or signs of bowel obstruction. Surgical clips are noted bilaterally indicating previous surgery.

Other findings of left paraumbilical small fat-containing hernia and enlarged prostate are also noted.

Case Discussion

CT provides the diagnosis of Spigelian hernia, shows its content, differentiates the subtypes, and demonstrates the presence of complications. 

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