Utility of CT in the diagnosis of an incarcerated Spigelian hernia without palpable abdominal mass

Ibrahima Niang,Sokhna Ba

doi:10.5348/101162z01in2020cr

Abstract

Introduction: Spigelian hernia is a rare type of ventral abdominal wall hernia. We report the case of an incarcerated Spigelian hernia without palpable abdominal mass diagnosed by computed tomography (CT) scan. Case Report: We report a case of a 63-year-old obese male patient with no particular pathological or surgical history received for bowel obstruction. The abdominal CT concluded to an incarcerated Spigelian hernia whereas this diagnosis was not considered at the clinical examination in the absence of visible or palpable mass on the anterolateral abdominal wall. Conclusion: This case report illustrates the key place of CT scan in this form of clinical presentation of Spigelian hernia.

Highlights

The generally narrow hernial ring is the cause of complications with the onset of bowel obstruction by incarceration [3]
We report the case of an incarcerated Spigelian hernia without palpable abdominal mass diagnosed by computed tomography (CT) scan
Elective surgical exploration centered on the mass confirmed the diagnosis of incarcerated Spigelian hernia, containing a viable content

Summary

INTRODUCTION

Spigelian hernia is a rare condition accounting for 0.1–2% of abdominal wall hernias in adults [1]. We report the case of an incarcerated Spigelian hernia without palpable abdominal mass diagnosed by computed tomography (CT) scan. This was a 63-year-old male, obese with a body mass index (BMI) of 34 without surgical history. It revealed a dilatation of small bowel, measured at 38 mm with a flat colon (Figure 1). Elective surgical exploration centered on the mass confirmed the diagnosis of incarcerated Spigelian hernia, containing a viable content (small bowel). There was no recurrence after four months of follow-up

DISCUSSION

Findings

CONCLUSION