Spigelian hernia. Misdiagnosis (initial diagnosis - lipoma ?) - Грыжа Спигелевой линии (липома ?).

The Spigelian Hernia was diagnosed in a patient during examination already on the operating table (in the preoperative room - immediately before the operation). Initially, this patient was admitted for outpatient removal of a subcutaneous lipoma of the anterior abdominal wall under local anesthesia. The diagnosis of Spiegelian hernia forced hernia repair with a sublay mesh implant under endotracheal anesthesia. A Spigelian is the type of ventral hernia where aponeurotic fascia pushes through a hole in the junction of the linea semilunaris and the arcuate line creating a bulge. It appears in the abdomen lower quadrant between an area of dense fibrous tissue and abdominal wall muscles (Spigelian aponeurosis). It is the protuberance, of omentum, adipose tissue, or bowel in that weak space between the abdominal wall muscles, that ultimately pushes the intestines or superficial fatty tissue through a hole causing a defect. Spigelian hernias are rare compared to other types of hernias because they do not dev