Epiploic appendage torsed within a spigelian hernia: US and CT findings

We report the sonographic and CT findings in a patient with an epiploic appendage strangulated within a Spigelian hernia sac. The patient presented with a small, tender, palpable mass, which, at sonography, was located within the abdominal wall, lateral to the rectus abdominis muscle, and had the appearance of an inflamed epiploic appendage. The same findings were confirmed by unenhanced CT. Surgery showed an epiploic appendage of the sigmoid colon within a small Spigelian hernia; the appendage was torsed around its pedicle at the entrance into the hernia sac. © 2011 Wiley Periodicals, Inc. J Clin Ultrasound, 2012