A RARE CASE OF GIANT SPIGELIAN HERNIA

Background - Spigelian hernia is an uncommon spontaneous lateral ventral hernia. It usually occurs below the arcuate line of Douglus. Incidence is 0.12 of all ventral hernias. Risk of strangulation is high and is around 20. It is very difficult to diagnose because of vague symptoms and usually requires radiological imaging when asymptomatic.Case study - We had a 55 year old female, with complaints of swelling pain in the left lower abdomen. It measures about 20x15cms in the left lateral border of rectus. Probable diagnosis of spigelian hernia was made. Abdominal x-rays didn't reveal any signs of intestinal obstruction. Ultrasonogram and CT confirmed the diagnosis of Spigelian hernia. So patient was taken up for surgery electively and open mesh repair was done. Postoperative period was uneventful and patient was discharged on 9th post-op day.Conclusion -Weakness presented in the linea semilunaris in Spigelian hernia may be caused either spontaneously or factors that increase the intra-abdominal pressure and this case is presented because of its rare occurrence and appropriate management .