Spigelian hernia

Case contributed by Dr MT Niknejad

Presentation

Right flank painless palpable mass on physical exam.

Patient Data

Age: 85 years
Gender: Female
CT

A 45 mm defect is seen at the right anterolateral aspect of the pelvic wall, between the lateral border of the rectus muscle and the semilunar line inferring right Spigelian hernia. Some small bowel loops, omental and mesenteric fats are herniated through it.

The spleen is enlarged, and its cephalocaudal height is measured 150 mm. 

Several nonenhanced simple cortical cysts are seen at both kidneys, with maximum diameters of 63 mm. In addition, a few tiny stones less than 3 mm are seen at both renal calyces.

Degenerative changes as osteophytosis are seen at the lumbar spine.
Scoliosis with rightward convexity is noted at lumbar spine.

Case Discussion

Spigelian hernia is a type of abdominal hernia along the semilunar line, resulting in herniation between the abdominal wall muscles, which may be congenital or acquired.

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