Case ReportLaparoscopic diagnosis and repair of Spigelian hernia: A case report and literature review

- The combination of physical exam findings and imaging is usually sufficient for the diagnosis of Spigelian hernias.
- Patient with chronic lower abdominal pain and with normal physical exam and imaging studies revealed to have a Spigelian hernia.
- Diagnostic laparoscopy of patient with chronic lower abdominal pain reveals Spigelian hernia with omentum.
- The omentum is reduced and the hernia defect is repaired.

IntroductionSpigelian hernias are a rare type of hernia which protrude through the abdominal wall at the semilunar line. They are especially difficult to diagnose due to their location and non-specific symptoms and are often overlooked because of their positioning between muscular layers. Patients may present with localized pain which can aid the diagnosis. CT and ultrasound are also helpful.Presentation of case: We present the case of a 75-year-old female patient who presented to Hialeah Hospital with a one-year history of abdominal pain localized to the left lower quadrant.DiscussionA Spigelian hernia containing omentum, was found during a diagnostic laparoscopy. The hernia was reduced, and the abdominal defect was repaired via primary repair, reinforced by mesh. The patient recovered uneventfully.ConclusionNonspecific physical exam findings and inconclusive imaging studies represented a diagnostic challenge. Here we discuss a case of a Spigelian hernia discovered through diagnostic laparoscopy.