Findings
Axial & coronal contrast CT sections of abdomen reveal interparietal right lower abdominal wall hernia with herniation of omental fat, vessels located lateral to semi lunar line between internal oblique and external oblique muscles. Minimal free fluid and fat stranding is seen in hernial sac. No herniation of bowel loops is seen. Empty right hemiscrotum is noted with right testes and epididymis located in inferior aspect of the hernial sac. No focal lesion is seen in testis.
Diagnosis
Spigelian-cryptorchidism syndrome: Right Spigelian hernia containing omental fat, right testis & epididymis.
Summary
Spigelian hernias are associated with cryptorchidism in the range of 28-75%. The anterior abdominal wall is a rare site for ectopic testis where Spigelian hernia is usually accompanied. For patients with an ectopic testis, the evaluation for a spigelian hernia should be done carefully. Similarly search for testis should be done in patients with Spigelian hernia.
Further reads
Emad-Eldin, S., Abdelaziz, O., & Shokr, M. (2021). Spigelian-cryptorchidism syndrome in an adult male complaining of primary infertility: Case report. Andrologia, 53(1), e13838. https://doi.org/10.1111/
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