{"ops":[{"insert":"A 50 year old woman presents with recurrent episodes of pain in the left lower abdomen for 1 year.\n\nThe pain did not worsen over time and was dull and aching in nature. It was worse on standing upright and walking while analgesics provided only poor relief.\n\nThere was no history of urinary or gastrointestinal symptoms. Her medical and surgical histories are unremarkable.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-S-020_en.png"}},{"insert":"\n"}]}
2
Investigate
Ultrasound Abdomen
{"ops":[{"insert":"The ultrasound scan shows a hernia with a sac ring of 0.6cm in the lower left abdomen consistent with a spigelian hernia\n"}]}
CT Abdomen
{"ops":[{"insert":"The CT scan shows a hernial sac protruding through a defect in the left linea semilunaris, and containing mesenteric fat; this corresponds to the area of abdominal tenderness.\n"}]}