Peer-reviewed veterinary case report
Sacless Spigelian hernia: a rare diagnostic and operative challenge-a case report.
By Brahma KS & Bharadwaj B.·2026·Department of General Surgery, India·View original on Europe PMC →
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Plain-English summary
A 52-year-old man had a rare type of hernia called a sacless Spigelian hernia, which means that fat was pushing through a weak spot in his abdominal wall without a protective sac. He noticed a lump in his lower left abdomen that would sometimes go away and had some pain. Doctors used a special camera to look inside his abdomen but didn't see a clear defect at first, so they had to do more exploration. They eventually found a small opening in the abdominal wall with fat tissue sticking out and repaired it with a mesh. The treatment was successful in addressing the hernia.
Abstract
Spigelian hernia is a rare ventral abdominal wall hernia occurring through a defect in the Spigelian aponeurosis along the semilunar line, accounting for 1%-2% of all abdominal wall hernias, with a high risk of incarceration due to its narrow and rigid fascial neck. A sacless variant, in which only preperitoneal fat protrudes without a peritoneal sac, is exceptionally rare and poses a diagnostic challenge. A 52-year-old male presented with a reducible left lower abdominal swelling and intermittent pain. Diagnostic laparoscopy showed intact peritoneum with no visible hernia defect. A strong clinical suspicion precluded conversion to open exploration, revealing a 2 × 3 cm defect in the Spigelian aponeurosis containing preperitoneal lipomatous tissue without a peritoneal sac. A preperitoneal mesh repair was undertaken. Sacless Spigelian hernia being extremely rare, a high index of suspicion and readiness for open exploration are essential when imaging and laparoscopy are inconclusive.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/42027579