Supraumbilical Spigelian hernia

Introduction: Spigelian hernia is an unusual pathology which incidence does not exceed 2 % of all hernias. Its presence at the supraumbilical abdominal wall is extremely rare. Case report: We report a case of a 46 year-old-woman who arrived to our Emergency Department with a painful, not reducible mass over the right upper abdominal quadrant. An abdominal ultrasound confirmed a little defect in the semi lunar line with protrusion of fatty content through it, which was suggestive of incarcerated Spigelian hernia. Open hernioplasty was carried out without intraoperative complications and the patient was disc harged from hospital 24 hours after intervention. Discussion: It usually appears among the "Spigelian hernia belt" and its aetiology could be congenital or acquired in most of cases. It is sometimes difficult to get a right clinical diagnosis, therefore imaging tests become necessary to confirm it. Surgical treatment is mandatory, and it could be done through an open or laparoscopic approach, both of them with few complications described. Spigelian hernias are a very rare condition described in the reviewed literature and we should be aware of them in order to diagnose and set up the best definitive treatment.