PMC5723272_01
Lump of 26 x 22 cm in right iliac fossa extending up to umbilicus & right hypochondrium.
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PMC5723272_01_gr1.jpg
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He was chronic bidi smoker for around 40 years.On examination there was a huge lump of 26 x 20 cm, occupying right iliac fossa extending up to umbilicus, right hypochondrium (Fig. 1) right lumbar and inguinal area (Fig. 2).
CECT showing defect at lateral border of right rectus muscle with bowel loops inside sac.
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PMC5723272_01_gr3.jpg
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CT scan for confirmation. CECT was done which showed a defect at lateral border of right rectus muscle with bowel loops inside sac (Fig. 3) and a final diagnosis of Spigelian hernia was made.After establishing the diagnosis of spigelian hernia operative intervention (laparoscopic/Open) planned.
Thinned out External Oblique Aponeurosis.
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PMC5723272_01_gr4.jpg
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The external oblique muscle and aponeurosis was extremely thin (Fig. 4) and hernia sac was lying in between external & internal oblique muscles (Fig. 5).