# Spigelian Hernia Masquerading as Chronic Lower Abdominal Pain: A Case Report

## TL;DR

A rare case of Spigelian hernia causing chronic abdominal pain was successfully treated with surgery after being misdiagnosed for years.

## Contribution

This case report adds to the understanding of the diagnostic challenges of Spigelian hernias and emphasizes the need for early imaging.

## Key findings

- Spigelian hernias can present as chronic abdominal pain and are often missed on clinical examination.
- Imaging is crucial for diagnosing Spigelian hernias when symptoms persist.
- Surgical repair with mesh leads to successful outcomes when the hernia is identified.

## Abstract

Spigelian hernias are rare and often overlooked causes of lower abdominal pain due to their deep location and subtle clinical signs. This case involves a 55-year-old woman with a five-year history of intermittent right lower abdominal discomfort that gradually worsened with physical activity. Clinical examination was inconclusive, prompting further evaluation with imaging, which revealed a defect in the Spigelian fascia with bowel herniation. She underwent successful open mesh repair, with an uneventful recovery and complete resolution of symptoms. This case highlights the diagnostic challenges associated with Spigelian hernias and underscores the importance of maintaining a high index of suspicion in patients with persistent, unexplained abdominal pain, as early imaging and surgical intervention can lead to excellent outcomes.