Rare presentation of incarcerated ventral hernia containing transverse colon diverticulitis

Ventral hernias are common abdominal wall defects; however, the presence of complicated diverticulitis within a hernia sac is exceedingly rare. We report the case of a 76-year-old female with multiple comorbidities who presented with acute left-sided abdominal pain and a tender, irreducible mass. Computed tomography imaging revealed a left lateral ventral hernia containing an inflamed diverticulum of the transverse colon. The patient underwent emergency hybrid laparoscopic surgery involving hernia sac resection, diverticulectomy, and primary abdominal wall repair. Her postoperative course was uneventful, and she was discharged on Day 5. This unusual presentation mimics both incarcerated hernia and acute diverticulitis, complicating diagnosis. Early imaging and prompt surgical management are vital to prevent life-threatening complications such as strangulation or perforation. This case emphasizes the importance of clinical awareness and individualized surgical strategies in managing complex ventral hernias. A multidisciplinary approach is essential for optimizing outcomes in rare and challenging abdominal emergencies.