Presentation
Recurrent abdominal pain associated with abdominal bump that grows with efforts.
Patient Data
There is a right Spigelian hernia containing the right Fallopian tube and ovary, which are enlarged. The right ovarian vein can be followed from the hernial sac back to the inferior vena cava, which supports the diagnosis.
With ultrasound, the hernial contents were confirmed. Hydrosalpinx and a multicystic ovary mass with wide septae and solid nodes were identified, these are features of an aggressive ovarian mass.
Case Discussion
Spigelian hernia is caused by a defect of the anterior abdominal wall, adjacent to the semilunar line, which represents the transition of the transverse muscle to aponeurosis.
There is a defect in the transversus aponeurosis, resulting in peritoneal contents protruding through the aponeurosis of the transversus and internal oblique muscles, spreading out under the external oblique aponeurosis, which is intact.
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