Spigelian hernia causing small bowel obstruction

Case contributed by Dr John Li

Presentation

Right lower abdominal lump associated with pain, nausea and vomiting. Nil previous surgical history

Patient Data

Age: 80 years
Gender: Male

Multiple dilated loops of small bowel throughout the abdomen including fecalised ileal loops in the right lower quadrant.  A transition point is identified within a right-sided Spigelian hernia which contains free fluid and a loop of distal ileum.  The hernia measures 54 x 21 mm in axial plane with a 25 mm neck. No evidence of pneumoperitoneum.

Case Discussion

This patient's hernia was reduced in the emergency department. They proceeded to a diagnostic laparoscopy to inspect the small bowel, which was viable, and a Spigelian hernia repair.

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Case information

rID: 59331
Published: 4th Apr 2018
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included
Institution: Gold Coast University Hospital

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