Spigelian Hernia: a Diagnostic Dilemma and Laparoscopic Mana
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Case Report
A 64-year-old lady with known history of hypertension and hypothyroidism was referred to the surgical clinic with history of on and off pain in the right lower abdomen for 2 months. Pain was mild to moderate in intensity. There was no history of fever, constipation, or urinary dysfunction; however, there was some heaviness in the right lower abdomen.

Patient also developed rashes due to herpes in the right lower abdomen during this period. The symptoms were thus initially attributed to herpes, and basic investigations were delayed. However, when the pain and heaviness persisted after the resolution of rashes, an ultrasound of the abdomen was ordered by the family physician. The USG came out to be normal except for fatty liver. The symptoms kept persisting, and hence, the patient was referred to a specialist center.

On presentation, the general examination of the patient was within normal limits. The abdomen was soft, and local temperature was not raised. There was tenderness along with a vague lumpiness in the right lumbar region. There was no impulse on coughing/straining. No organomegaly or other significant finding was present.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425759/
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