A Case of Spigelian Hernia Diagnosed by Abdominal Computed Tomograpy.

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  • ＣＴにて術前診断した半月状線ヘルニアの１例

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Abstract

Spigelian hernia is an extremely rare abdominal hernia. A 65-year-old woman was seen at the hospital because of a localized bulge and pain in the right lower quadrant lasting for about one year. On a physical examination, a soft bulge 3×3cm in size with tenderness was palpable. Abdominal CT scanning showed that the aponeurosis under the bulge was defected by the lateral border of rectus abdomens muscle and the intra-abdominal content was protruded through this defect. Under a diagnosis of Spigelian hernia, we carried out a reduction of the hernia sac under general anethesia, and closed the hernia. At surgery, the hernia sac was found to prolapse from a defect of lacertus at the external abdominis oblique aponeurosis. The sac contained the omentum. The patiant was discharged from the hospital without pain on the 7th postoperative day. Spigelan hernia is so rare that only 19 cases have been reported in the Japanese literature. We have difficulty in making diagnosis by limited knowledge of this disease. In this case, abdominal CT scanning was useful for preoperative diagnosis.

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