Occult Spigelian Hernia Diagnosed on CT Imaging: A Rare Case Report

Abstract

Spigelian hernia is a rare ventral abdominal wall hernia that often presents a diagnostic challenge because of its interparietal location and absence of obvious external swelling. We report the case of a 75-year-old male who presented with a reducible right iliac fossa swelling that increased on straining. Clinical findings were subtle, and contrast-enhanced CT imaging revealed a Spigelian hernia containing omental fat with associated fat stranding and early inflammatory changes. The patient underwent successful open onlay mesh repair with an uneventful postoperative recovery. This case underlines the role of CT imaging in accurately diagnosing Spigelian hernia and guiding timely surgical management.