HighlightsThe combination of physical exam findings and imaging is usually sufficient for the diagnosis of Spigelian hernias.Patient with chronic lower abdominal pain and with normal physical exam and imaging studies revealed to have a Spigelian hernia.Diagnostic laparoscopy of patient with chronic lower abdominal pain reveals Spigelian hernia with omentum.The omentum is reduced and the hernia defect is repaired.
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