RESUMEN
INTRODUCTION AND IMPORTANCE: Spigelian hernia is a rare abdominal wall hernia, representing 0.1 to 2 % of all ventral hernias. Clinically, the signs and symptoms are nonspecific and unclear. CASE PRESENTATION: Here, we present a 69-year-old female patient, with abdominal bulging in both iliac fossae. Imaging exams suggested Spigelian hernia and right inguinal hernia. The treatment was surgical, with placement of polypropylene meshes and the patient had an uneventful postoperative evolution. CLINICAL DISCUSSION: The characteristics of this case corroborate the current literature, which points to a greater involvement of adults aged between 40 and 70 years. The treatment of choice is surgery, which can be open or videolaparoscopic, with placement of a mesh or primary suture. CONCLUSION: The clinical presentation of Spigelian hernia is not characteristic and its diagnosis should be suspected during the investigation of an abdominal mass.