A Case of Nonincarcerated Bilateral Metachronous Spigelian Hernia

Shintaro Nakajima, Katsuhito Suwa, Kazuo Kitagawa, Tetsuya Yamagata, Tomoyoshi Okamoto and Katsuhiko Yanaga*

Department of Surgery, Daisan Hospital, Jikei University School of Medicine
Department of Surgery, Department of Gastroenterological Surgery, Jikei University School of Medicine*

We report a case of nonincarcerated bilateral metachronous Spigelian hernia. A 54 years old woman operated in September 2001 for a right Spigelian hernia was seen in September 2007 for a bulging mass in the left central abdomen. The mass protruded from the abdominal wall when the women clenched her abdominal muscles, but produced no pain. The hernia was easy repositionable and its orifice 2 cm in diameter, could be palpated. Computed Tomography showed a sac protruding subcutaneously near the external margin of the rectus abdominis muscle. Based on a diagnosis of left nonincarcerated asynchronous Spigelian hernia, elective surgery was conducted under general anesthesia to repair the hernia with a Composix kugel patch. Intraoperatively, the hernia orifice was 1.5×1.5 cm and presented as a complete defect between the rectus and the internal/external oblique and transversus muscles. Her postoperative course was uneventful and she was discharged on postoperative day 8. No recurrence has been observed during 15-month follow-up.

Key words
spigelian hernia, bilateral, metachronous

Reprint requests
Shintaro Nakajima Department of Surgery, Daisan Hospital, Jikei University School of Medicine
4-11-1 Izumihoncho, Komae, 201-8601 JAPAN

Accepted
July 22, 2009

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