Incarcerated Spigelian hernia: A rare cause of abdominal wall tender mass

Abstract

In this study, we aimed to present that incarcerated Spigelian hernia is an important cause of acute abdomen although it is rareand accounts for 1–2% of all abdominal wall hernias. Spigelian hernia arises from a defect in the aponeurosis of the transversus abdominis muscle, also known as the Spiegel fascia. This case analysis aims to present a Spigelian hernia case in which thesigmoid colon is incarcerated. The patient was referred to our emergency surgery clinic complaining of severe abdominal painand a palpable mass in the left quadrant of the abdomen, presenting tenderness on the front abdominal wall. The symptomssuddenly emerged approximately eight hours ago before the patient was admitted to the hospital. The patient was taken intosurgery after the ultrasonography (US) and computed tomography (CT) results suggested a preliminary diagnosis of incarcerated Spigelian hernia for which polypropylene mesh repair was performed. No recurrence was identified in the patient’s controlexamination performed 22 months later. Incarcerated Speigel hernia should be considered as a cause for patients developingsudden stomach ache and mass, causing tenderness on the front abdominal wall for which mesh repair should be performed.