Presentation
Right lower abdominal lump associated with pain, nausea and vomiting. Nil previous surgical history
Patient Data
Multiple dilated loops of small bowel throughout the abdomen including fecalised ileal loops in the right lower quadrant. A transition point is identified within a right-sided Spigelian hernia which contains free fluid and a loop of distal ileum. The hernia measures 54 x 21 mm in axial plane with a 25 mm neck. No evidence of pneumoperitoneum.
Case Discussion
This patient's hernia was reduced in the emergency department. They proceeded to a diagnostic laparoscopy to inspect the small bowel, which was viable, and a Spigelian hernia repair.