Spigelian hernia represents 0.1 to 2% of abdominal wall hernias; It is a defect in the aponeurosis of the transverse and oblique abdominal muscles between the lateral border of the rectus abdominis sheath and the semilunar line. CLINICAL CASE. A 43-year-old male with morbid obesity, type 2 Diabetes Mellitus, and Systemic Arterial Hypertension. He started suffering from abdominal pain of more than 36 hours of evolution, nausea and vomiting of gastro biliary content, and a fever of 38.7 ° C; found a painful tumor, which indicated a Computed Axial Tomography, which reported intestinal obstruction and hernial defect of the abdominal wall. Indicated Exploratory Laparotomy. Made a supra and infra umbilical incision in the previous scar. It is dissected by planes, finding a three cm hernial defect in the upper vertex of the previous scar with a fibrous sac, adhesions, and transverse colon content without vascular compromise and reduced content. Subsequently, we proceeded to identify a right paramedian ventral hernia with a six cm defect without being able to reduce the hernial sac along the midline, for which is made a right transverse incision; dissected by planes, identifying hernial sac with necrotic, fetid, non-perforated small intestine contents, performed adhesiolysis, reduced the defect, and performed a 150 cm ileum resection with stump closure; washed the cavity, the stoma was exteriorized and matured, and it was closed in layers. DISCUSSION. Spigelian hernia is a rare differential diagnosis of abdominal pain. This type of hernia mainly affects women over the fifth decade of life, with a higher incidence on the left side, generally with comorbidities that lead to increased intra-abdominal pressure or weakened abdominal fascia, such as COPD, cirrhosis, obesity, and pregnancy.
Spigelian hernia; Incarceration; sigmoid colon; General surgery; Hernia surgery
Rodríguez-Sosa S.H., Nogueira-Echeverría A.E., Rubio-Zapata H.A., Cruz-Mendez A.T., Rodríguez-Herrera C.J., Vidales-López R.A., Pat-Cruz F.J., Sollano-Shivy S.D., Padrón-Arredondo G. Intestinal Obstruction Secondary to Strangulated Spigelian Hernia: A Rare Entity. Int. J. Med. Healthc. Res., 2023, 1(1), doi: 10.58531/ijmhr/1/1/4
