case_images: PMC6277219_01
case_images: Mass in the lower left abdomen.
case_images: gr1.jpg
case_images: PMC6277219_01_gr1.jpg
case_images: fig0005
case_images: A tender mass measuring about 10 cm by 8 cm was present in the left iliac fossa region of the abdomen (Fig. 1).
case_images: Ultrasound showing the mass appearing cystic.
case_images: gr2.jpg
case_images: PMC6277219_01_gr2.jpg
case_images: fig0010
case_images: Investigations done by the patient at the referring hospital included an abdomino-pelvic Ultrasound scan which revealed a cystic mass of about 45mls volume suggestive of mesenteric hematoma (Fig. 2) and a computed tomography (CT) scan which was suggestive of an obstructed spigelian hernia with the sac containing a small bowel loop and mesentery (Fig. 3).
case_images: Spigelian hernal sac.
case_images: gr4.jpg
case_images: PMC6277219_01_gr4.jpg
case_images: fig0020
case_images: Under general anaesthesia, a transverse left lower abdominal incision was made and findings were herniation through a facial defect of about 5 cm by 4 cm along the lateral border of the rectus sheath (Fig. 4).
case_images: Strangulated segment of ileum.
case_images: gr5.jpg
case_images: PMC6277219_01_gr5.jpg
case_images: fig0025
case_images: Hernia sac contained sero-sanguineous peritoneal fluid, gangrenous ileal segment (Fig. 5) and part of herniated urinary bladder forming the lower wall of the sac (Fig. 6).
case_images: Nylon darn.
case_images: gr7.jpg
case_images: PMC6277219_01_gr7.jpg
case_images: fig0035
case_images: In addition, nylon darning from inguinal ligament to the rectus sheath was also done (Fig. 7).
case_images: Closure of the external oblique aponeurosis.
case_images: gr8.jpg
case_images: PMC6277219_01_gr8.jpg
case_images: fig0040
case_images: Then closure of external oblique aponeurosis. (Fig. 8).