The Utility of Dynamic Maneuvers in the Sonographic Diagnosis of Spigelian Hernia: A Case Report

A Spigelian hernia is an uncommon type of abdominal wall hernia that is often difficult to diagnose clinically due to its subtle presentation and deep anatomical location between layers of the abdominal wall. It is a rare type of abdominal hernia that allows abdominal contents to push through a fault in the Spigelian fascia. As such, primary care providers should consider imaging when clinical findings are inconclusive. Sonographers and sonologists should always keep a Spigelian hernia as one of the differential diagnoses for superficial masses, within the anterior abdominal wall. The present case provided is of a 65-year-old woman with a 5-year history of intermittent left lower quadrant abdominal pain. She was referred by her primary care provider, initially misdiagnosed until sonographic assessment confirmed a Spigelian hernia. This case report underscores the diagnostic value of dynamic sonography in detecting Spigelian hernias, which are often overlooked or missed.