Spigelian hernia

Case contributed by Dr Ashraf Ali Mohammad Mahran

Presentation

Severe left pelvic pain.

Patient Data

Age: 35 years
Gender: Female
Ultrasound

A dilated viscous seen herniated through an area of weakness at the junction between abdominal wall muscles at the left side of the pelvis, no signals seen within the herniated viscous on color Doppler.

Ultrasound

Annotated image, showing the relations of the muscles.  

Case Discussion

CT study is the modality of choice in the diagnosis of different types of hernia and is better at differentiating Spigelian hernia. Ultrasound examination can detect Spigelian hernia as well, and is preferred than CT to exclude strangulation and ischemia by color Doppler study. Also, a linear probe gives more details than a curvilinear probe in the diagnosis of Spigelian hernia as it is related to the musculoskeletal system. 

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