Case report: acute appendicitis in a Spigelian hernia

Spiegel's hernia is a rare condition, accounting for 0.12% to 2% of abdominal hernias. Spiegel's hernias are defined as a protrusion through a defect in the Spiegel fascia, which is located along the semilunar line. This line marks the transition zone between the lateral border of the rectus abdominis muscle and the aponeurotic insertions of the lateral abdominal muscles. A 70-year-old female patient presented with localized lower right abdominal pain lasting for 7 days, accompanied by a palpable mass within a defect in the abdominal wall. During surgical intervention, a Spiegel's hernia with acute appendicitis (complicated acute appendicitis) was identified inside the hernial sac. An appendectomy was performed, along with primary closure of the hernial defect. Spiegel's hernia is infrequently encountered, and the presence of acute appendicitis within the hernial sac is even more uncommon. Therefore, clinical findings should be correlated with imaging and laboratory studies to establish an accurate diagnosis.