Spigelian hernia with Richter-type herniation of the ileum: A rare cause of right iliac fossa pain mimicking acute appendicitis

We report a case of a sixty-two-year-old man who presented to the emergency department with severe right iliac fossa pain. The patient was clinically diagnosed as having acute appendicitis and was referred for an abdominal CT scan. Abdominal CT revealed a Spigelian hernia with Richter-type herniation of the small bowel without any significant bowel obstruction. The patient underwent immediate surgical repair and the postoperative course was uneventful. This is a rare association of two rare conditions mimicking a common disease such as appendicitis.