A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Management remains surgical with various techniques emerging over the years. Lumbar hernias occur in the region of the flank bounded by the 12th rib, the iliac crest, and the erector spinae and external oblique muscles. In fact, this hernia occurs so infrequently that only an occasional surgeon has the opportunity of seeing and repairing one through the course of his entire life. Most common in patients aged between 50 and 70 years with a male predominance 1. Lumbar hernia is a relatively rare defect of the posterior abdominal wall, with approximately 300 cases reported in the literature. Theres a natural weak spot in the lower back called the superior lumbar triangle or grynfelttlesshaft triangle.
Authors have reported repairing primary inferior and superior lumbar hernias using laparoscopic,14 or endoscopic extraperitoneal techniques. Acute traumatic lumbar hernia is a rare type of abdominal wall hernia, occurring in either the grynfelttlesshaft triangle or in petits triangle. A lumbar hernia is the protrusion of intraperitoneal or extraperitoneal contents through a defect of the posterolateral abdominal wall figure 4. Eighty percent of lumbar hernias are acquired, meaning they develop over time due to weakness of the abdomen wall and loss of muscle and. A lumbar hernia may be primary or secondary with only about 300 cases of primary lumbar hernia reported in literature.
What are the treatment options for a lumbar hernia. A lumbar hernia is a rare pathological derangement of anatomy, especially when the postoperative type is excluded. Soon after that, the patient had a recurrent bulge in his right flank area requiring him to wear a truss to hold it in and prevent discomfort. Hernia v lumbar and obturator hernias netter images. Lumbar hernia misdiagnosed as a subcutaneous lipoma.
Because a lumbar hernia is a type of abdominal hernia, it needs surgery to treat the opening in the abdomen wall. Groin hernias are most commonly of the inguinal type but may also be femoral. Lumbar hernia is an uncommon abdominal wall hernia, making its diagnosis and management a challenge to the treating surgeon. Here, we present a case of secondary lumbar hernia. Acquired lumbar hernias may follow trauma, poliomyelitis, loin incision, and the use of iliac crest as a donor site for bone grafting. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. They are typically subdivided by categories such as congenital or acquired and by their location. A spontaneous regression of their hernia was appreciated as follow. We present the ct findings of seven lumbar hernias. Patients with lumbar hernia are usually asymptomatic but may complain of backache, flank pain or a dragging sensation. Lumbar hernias are rare clinical entities with less than 400 reported in the literature. We would like to show you a description here but the site wont allow us.
The superior lumbar triangle, also known as the triangle of grynfelttlesshaft, is one of the locations for a lumbar hernia. Lumbar hernia is a rare abdominal wall defect and clinical suspicion is necessary for diagnosis. We report the case of a 40yearold caucasian woman with a superior lumbar hernia grynfeltt hernia initially misdiagnosed as a recurrent lipoma. A year later, he was noted to have a right lumbar incisional hernia that was repaired with a polypropylene mesh. Lumbar hernias manifest through two possible defects in the posterior abdominal wall, the superior being more common. Two larger studies involving lumbar hernia repairs have been reported. An imaging study forms an indispensable aid in the diagnosis and surgery is the only treatment option. Lumbar hernia definition of lumbar hernia by medical dictionary. Laparoscopic lumbar hernia repair sages abstract archives. Our technique uses the same welldescribed methods for. You may not embed one of our images on your web page without a link back to our site.
Ana mara paredes perez asistente servicio radiologiahospital nacional arzobispo loayza. Barbette was the first, in 1672, to suggest the existence of lumbar hernias. Lumbar hernia definition of lumbar hernia by medical. Presentation may be misleading and diagnosis often missed. Fei and li reported on 41 flank hernias which were repaired either by an. Most commonly they involve the abdomen, specifically the groin. Microsurgical technique in surgery for lumbar disc herniation. Typically, the location of the hernia defect, occurring more commonly at points of anatomic weakness in the lower abdomen, correlates poorly with the site of impact. The patient was free of recurrence at 4 months after. Department of surgery, university of washington introduction. It is named after french surgeon jean louis petit 16741750.
According to hafner et al, 1 a general surgeon will only have the opportunity to repair 1 lumbar hernia case in his or her lifetime. In most cases, lumbar hernias are the result of aging. Laparoscopic repair of acquired lumbar hernia springerlink. On admission, ecchymotic, fluctuating swelling was present on his left flank with normal vital signs. Patients with lumbar hernias can present with a variety of symptoms, including a posterolateral mass, back pain, bowel obstruction if contents contain bowel, or urinary obstruction if contents are. If you would like a large, unwatermarked image for your web page or. The correct diagnosis was made intraoperatively and the hernia was repaired using synthetic mesh. Honor society of nursing stti lumbar hernias can be congenital or the result of injury or trauma to the back or abdomen. These hernias have a natural history of a gradual increase in size over time. If you would like a large, unwatermarked image for your web page or blog, please purchase the appropriate license. If symptoms are present, they include back or flank pain or a dragging sensation.
In fact, this hernia occurs so infrequently that only an occasional surgeon has the opportunity of seeing and repairing one. He was referred to us for repair of his recurrent lumbar incisional hernia. Surgery will depend on the size and severity of the hernia. Dec 10, 2009 lumbar hernia is a rare abdominal wall defect and clinical suspicion is necessary for diagnosis. Two types are described, according to the anatomical location of the hernial neck. A petits lumbar hernia is, indeed, an extremely rare defect. Other hernias include hiatus, incisional, and umbilical hernias.