Non-strangulated Spigelian Hernia: A Case Report

Spigelian hernia is a rare type of 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 74-year-old female presented with progressively worsening left flank pain along with dysuria and frequency related to pyelonephritis. Incidentally, CT of the abdomen and pelvis demonstrated a left spigelian hernia containing intermediate size small bowel without strangulation. Thereafter, she began developing increasing abdominal pain in that area. The hernia was repaired on the same day as admission via laparoscopic intraperitoneal onlay mesh-plus repair. Spigelian hernia possesses an elusive clinical presentation. Though rare, it must be considered in the differential diagnosis of abdominal hernia due to its high risk for acute complications.