Background: Spigelian hernia (SH) is rare and constitutes less than 2% of all hernias. It is reported that more than\n90% of SHs lie in the â??Spigelian beltâ?, but SH in the upper abdominal wall is extremely uncommon. Here, we report\na case of SH in the right upper quadrant of abdomen.\nCase presentation: A 38-year-old female was admitted to hospital with complaints of abdominal pain and right\nupper quadrant mass for 10 days. Contrast-enhanced computed tomography (CECT) of abdomen revealed the\ndilated small intestine between the swelling ventral muscles in the right upper abdominal wall which suggested a\nventral hernia. The surgeons considered it was a spontaneous hernia because there was no history of surgery or\ntrauma in the upper abdomen. About two hours later, the patient underwent emergency surgery. According to\nlaparotomy, a diagnosis of SH with ileum herniation in the right upper abdominal wall was confirmed. The necrotic\nileum segment was resected. Meanwhile the abdominal wall defect was repaired by suturing the internal oblique\nand transverse muscles to the rectus sheath. The patient had a favorable outcome for 1 year without recurrence.\nConclusion: A mass and pain in the upper abdominal wall may suggest an atypical SH. SH occurring in the upper\nabdominal wall is a rare condition with possibility of dire outcome if not managed early.
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