Presentation
Post bariatry abdominal swellings
Patient Data
17 mm superior and just to the left of midline of the umbilicus is a 7 x 7 mm abdominal wall defect with herniation of omentum as content. Hernia sac measures 3.3 x 3.3 x 4.0 cm (TR x AP x CC). Mild fluid within sac.
5 cm above the umbilicus and 8 cm to the left of midline is a Spigelian hernia defect 3.0 x 2.7 cm. Hernia sac measures 11.0 x 9.5 x 4.2 cm (TR x AP x CC). It has omentum and terminal third of transverse colon afferent and efferent loops as content.
Case Discussion
A nice demonstration of a paraumbilical and Spigelian hernia. Always document if there are any signs of bowel incarceration in the hernia sac.