Spigelian Hernia Masquerading as Chronic Lower Abdominal Pain: A Case Report

Spigelian hernias are rare and often overlooked causes of lower abdominal pain due to their deep location and subtle clinical signs. This case involves a 55-year-old woman with a five-year history of intermittent right lower abdominal discomfort that gradually worsened with physical activity. Clinical examination was inconclusive, prompting further evaluation with imaging, which revealed a defect in the Spigelian fascia with bowel herniation. She underwent successful open mesh repair, with an uneventful recovery and complete resolution of symptoms. This case highlights the diagnostic challenges associated with Spigelian hernias and underscores the importance of maintaining a high index of suspicion in patients with persistent, unexplained abdominal pain, as early imaging and surgical intervention can lead to excellent outcomes.