Spigelian Hernia of Stomach with Gastric Outlet Obstruction.

A 79-year-old woman who had received exploratory laparotomy presented with a 1-day history of lower abdominal pain and vomiting. She had a non-reducible mass in the left lower abdomen that protruded more prominently on the application of abdominal pressure. Radiography (Picture 1) and computed tomography showed a hernia sac at the stomach (Picture 2), with a transitional zone in the abdominal defect (arrow) and gastric distension. Incarcerated Spigelian hernia of the stomach with gastric outlet obstruction was diagnosed. During the operation, the surgeon confirmed that the hernia had occurred between the meniscus and rectus muscle, and mesh repair was performed (asterisk, Picture 3). Spigelian hernia, which was first reported by Holloway (1) and Spangen (2), is a rare type (only 0.12%) of abdominal wall hernia that occurs through a defect formed in the Spigelian aponeurosis and usually present in the lower abdomen, where the posterior sheath is deficient. We encountered an extremely rare stomach-type Spigelian hernia, and prompt surgery is indicated given its high rate of incarceration.

Picture 1.

Picture 2.

Picture 3.

The authors state that they have no Conflict of Interest (COI).