BACKGROUND: Spigelian hernia, or lateral ventral hernia, is rare and represents between 0.1–2% of all hernias of the abdominal wall. The presentation is variable, and the diagnosis may be challenging. This report is of an unusual case of Spigelian hernia that contained part of a fibroid uterus and the left adnexa.

CASE REPORT: A 66-year-old woman presented with an abdominal wall mass in the left lower quadrant. On physical examination, a provisional diagnosis of ventral hernia was made. Abdominal computed tomography (CT) imaging showed an unusual Spigelian hernia that contained part of a fibroid uterus and the left adnexa. Treatment using laparoscopic hysterectomy, left salpingo-oophorectomy, and hernia repair was successfully performed jointly by a general surgeon and a gynecologist.

CONCLUSIONS: To the best of our knowledge, the is the first reported case of Spigelian hernia that contained part of the uterus and the left adnexa.

Keywords: Hernia, Abdominal, Hysterectomy, Uterus, Abdominal Wall, Adnexa Uteri, Hernia, Ventral, herniorrhaphy, Laparoscopy, Leiomyoma, multidetector computed tomography, Salpingo-oophorectomy