Spigelian hernia causing small bowel obstruction

Case contributed by Dr Mohammed Al Khader.O.Thabet

Presentation

Known case of left renal stone presented with right iliac fossa pain, to rule out appendicitis.

Patient Data

Age: Adult
Gender: Female

Herniated distal ileal loops & omental fat through defect within the semilunar line, located just posterolateral to lateral border of right rectus abdominis. The herniated bowel is located deep to the right external oblique muscle. There is associated diltation of afferent loop of the herniated bowel and ileal and jejunal bowel loops, with small bowel faeces sign noted just proximal to site of obstruction. Finding are consistent with a Spigelian hernia causing small bowel obstruction.

Case Discussion

A spigelian hernia should not be overlooked clinically as there is a risk of obstruction of herniated  intestinal loops - as in this case of a patient who presented with right iliac fossa pain.

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Case Information

rID: 26832
Case created: 9th Jan 2014
Last edited: 9th Sep 2015
Inclusion in quiz mode: Included

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