A not so common abdominal wall hernia with a diagnostic dilemma! - Irreducible Spigelian hernia

A Spigelian hernia, a rare variant of an abdominal wall hernia, tends to be a diagnostic challenge for many surgeons. Protruding through the spigelian fascia, between the semilunar line laterally, and the lateral border of the rectus medially, this condition presents unlike most other hernias, due to the tensile strength of the anteriorly placed external oblique fascia. We present such a case which was clinically diagnosed as a subcutaneous lipoma causing a diagnostic dilemma, along with a relevant review of literature.