Rare Case of Incarcerated Bilateral Spigelian Hernia in Ghana: A Case Report and Literature Review

Spigelian hernia is an uncommon form of abdominal wall hernia. The symptoms can be insidious but the commonest are abdominal pain or a lump on the anterior abdominal wall. Diagnosis can be challenging, but the use of ultrasonography and contrast enhanced CT (CECT) scan is essential to avoid diagnostic delays. In view of a high risk of incarceration and strangulation anticipated, urgent operative intervention is necessary. In this case report, a 42-year old multiparous woman presented with bilateral lumps on the abdominal wall and abdominal pain with no symptoms or signs of obstruction or strangulation. The clinical evaluation was suspicious of bilateral spigelian hernia. This was confirmed by CECT scan of abdomen as ultrasonography was inconclusive. This case report illustrates the diagnostic challenges of spigelian hernia and how early operative intervention is crucial to preventing strangulation.