Simultaneous umbilical, Spigelian and bilateral inguinal hernias with partial urinary bladder herniation: A rare radiological presentation

ABSTRACT: Spigelian hernia is a rare type of ventral abdominal wall hernia, and urinary bladder herniation into the inguinal canal is an uncommon complication typically seen in elderly males. The simultaneous occurrence of multiple abdominal wall hernias with bladder involvement is exceedingly rare and diagnostically challenging. We present the case of a 62-year-old male who underwent abdominal computed tomography (CT) due to chronic lower abdominal discomfort and right groin swelling. Imaging revealed a small midline umbilical hernia, a right-sided Spigelian hernia, bilateral inguinal hernias and partial urinary bladder herniation into the right inguinal canal. All hernias were clearly visualised on contrast-enhanced CT with multiplanar reconstructions. While individual hernias are common, the coexistence of four different types - particularly with bladder involvement - has not been previously reported in the radiological literature. Accurate CT imaging was instrumental in detecting the defects and guiding referral for surgical management. This case highlights the importance of comprehensive cross-sectional imaging in elderly patients with nonspecific abdominal or groin symptoms. This rare case underscores the diagnostic value of CT in identifying multiple synchronous abdominal wall hernias and emphasises the need to consider urinary bladder herniation in the differential diagnosis, especially in older male patients.