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An Unusual Case of Left Spigelian Hernia Containing Part of a Fibroid Uterus and the Left Adnexa in a 66-Year-Old Woman

Gregory Nicolas, Nancy Emmanuel, Charlotte Charbel, Adnan Awdeh, Brian Bitar, Salam S. Abourafeh, Madeleine Farah, Leya Daher, Abdul Aziz Mhanna, George Khoury

(Department of Surgery, Lebanese American University Medical Center, Beirut, Lebanon)

Am J Case Rep 2019; 20:1643-1647

DOI: 10.12659/AJCR.917104

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

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