Management of Non - Strangulated Left Lower Quadrant Spigelian Hernia: A Rare Presentation and Surgical Approach

Dr. Vasu Nikunj, Dr. Magesh Kumar

Abstract: Spigelian hernia (SH) is a rare ventral hernia with an incidence of 0.1 - 2%. We report a case of a non - strangulated left lower quadrant Spigelian hernia and its management. A 43 - year - old female presented with gradually progressive swelling associated with vague pain in the left lower abdomen. Contrast - Enhanced Computed tomography (CECT) of the abdomen and pelvis demonstrated a left SH containing intermediate - sized small bowel and omentum without strangulation. The hernia was repaired via an open approach using polypropylene mesh. The post - op course was uneventful. SH usually possesses a vague clinical presentation which is confirmed in most cases by imaging only. All diagnosed SH should be planned for elective operation to prevent it from strangulation which then becomes an emergency surgery. The definitive treatment is surgery either by open or laparoscopic approach, depending on the surgeon?s experience. In most cases, a mesh repair is generally advised. Though the presentation is rare, it must be considered in the differential diagnosis of abdominal hernia due to its high risk for acute complications.

Keywords: Spigelian hernia, Strangulation, Surgery, Semilunar line