There are typical features of incarcerated hernia demonstrated by a narrow neck and proximal small bowel obstruction. The site of hernia is specific for spigelian hernia, which is between the lateral border of rectus abdominis muscle and the semilunar line.

Spigelian hernia or lateral ventral hernia is very uncommon with an estimated incidence of 0.1% of abdominal wall hernias. Incarcerated spigelian hernia associated with small bowel obstruction is very rare.

Imaging is vital in abdominal emergencies. It is of utmost importance in clinically occult cases, especially in diagnosing complications like incarceration, strangulation, obstruction and necrosis, which might be a surgical emergency.

Additional case author: Dr Palak Thakrar ([email protected])