EURORAD ESR

Case 14465

An unusual case of right lower quadrant pain: Spigelian hernia

Author(s)
Maria Ana Serrado1, Sofia Dutra2, José Maria Barros3

1Hospital Nélio Mendonça, SESARAM E.P.E., Serviço de Imagiologia; Avenida Luís de Camões 9004-514 Funchal, Portugal; Email:m_serrado@hotmail.com
2Hospital do Divino Espírito Santo de Ponta Delgada, Serviço de Radiologia; Rua Grotinha 9500-370 Ponta Delgada, Portugal
3Hospital São José, Centro Hospitalar Lisboa Central, E.P.E., Departamento de Radiologia; Rua José António Serrano, 1150-199 Lisboa, Portugal
 
Patient
female, 65 year(s)
 
 
  • Figure 1
    Spigelian hernia
     

    Axial contrast enhanced CT shows a right-sided lower quadrant hernia, through a 3-cm defect located between the anterior rectus muscle and oblique muscles into the subcutaneous planes, consistent with Spigelian hernia.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;

    Coronal contrast enhanced CT shows a right-sided lower quadrant Spigelian hernia and mild stranding of the herniated fat.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;

    Sagital non enhanced CT shows a right-sided lower quadrant Spigelian hernia. Note the normal retro-caecal appendix (white arrow).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;
     
     
  • Figure 2
    Schematic anatomy of the anterior abdominal wall
     

    Diagram of the anterior abdominal wall shows the location of Spigelian hernias. Left rectus abdominis muscle ressected.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;

    Diagram of the anterior abdominal wall above the semicircular line, axial view.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;

    Diagram of the anterior abdominal wall below the semicircular line, axial view.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Hernia;
     
     
Axial contrast enhanced CT shows a right-sided lower quadrant hernia, through a 3-cm defect located between the anterior rectus muscle and oblique muscles into the subcutaneous planes, consistent with Spigelian hernia.
 
Coronal contrast enhanced CT shows a right-sided lower quadrant Spigelian hernia and mild stranding of the herniated fat.
 
Sagital non enhanced CT shows a right-sided lower quadrant Spigelian hernia. Note the normal retro-caecal appendix (white arrow).
 
Diagram of the anterior abdominal wall shows the location of Spigelian hernias. Left rectus abdominis muscle ressected.
 
Diagram of the anterior abdominal wall above the semicircular line, axial view.
 
Diagram of the anterior abdominal wall below the semicircular line, axial view.
 
 
 
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