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2007, Number 5

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Cir Cir 2007; 75 (5)

Lumbar hernia. Case report and literature review

Tavares-de la Paz LA, Martínez-Ordaz JL

Language: Spanish
References: 31
Page: 381-384
PDF size: 74.32 Kb.


ABSTRACT

Background. Lumbar hernia is a rare abdominal wall defect that usually presents spontaneously after trauma or lumbar surgery or, less frequently, during infancy (congenital). Few reports have been published in the literature describing congenital lumbar hernia.
Case report. We present the case of a patient with congenital lumbar hernia and a review describing the regional anatomy, laparoscopic techniques as a surgical alternative, and the impact of modern imagenology in diagnosis, confirmation and demarcation of the aponeurotic defect, in order to update information and to provide the surgeon with the tools for optimal perioperative preparation and the best operative technique for this rare disease. We describe here the case of a 5-month-old Mexican female infant with a right lumbar bulging. Ultrasono- graphic findings showed an aponeurotic defect and an ipsilateral renal agenesia. Open surgical repair was carried out with identification of the defect in the superior or Grynfellt-Lesshaft’s triangle and the inferior triangle as well, and a polypropylene mesh was placed below the posterior abdominal sheath.
Conclusions: Congenital lumbar hernia usually originates in the superior triangle or Grynfellt-Lesshaft’s triangle and is frequently associated with the lumbocostovertebral syndrome. Surgery is always indicated, with utilization of prosthetic material or muscular flaps as the best repair technique.


REFERENCES

  1. 1. Geis WP, Saleta JD. Lumbar hernia. In: Nyhusand LM, Condon RE, Hernias. 3rd ed. Philadelphia: JB Lippincott;1989. p. 401.

  2. 2. Heniford BT, Iannitti D, Gagner M. Laparoscopic inferior and superior lumbar hernia repair. Arch Surg 1997;132:1141-1144.

  3. 3. Lawdahl RB, Moss CN, Van Dyke JA. Inferior lumbar (Petit’s) hernia. AJR 1986;147:744-745.

  4. 4. Burt BM, Afifi HY, Wantz GE, Barie PS. Traumatic lumbar hernia: report of cases and comprehensive review of the literature. J Trauma 2004;57:1361-1370.

  5. 5. Thorek M. Lumbar hernia. J Int Coll Surg 1950;14:367-393.

  6. 6. Nyhus LM, Bombeck CT, Klein MS. Hernias. In: Sabiston DC, ed. Textbook of Surgery, 13th ed. Philadelphia: WB Saunders;1986. pp. 1250-1251.

  7. 7. Esposito TJ, Fedorak I. Traumatic lumbar hernia: case report and literature review. J Trauma 1994;37:123-126.

  8. 8. Somuncu S, Bernay F, Rizalar R, Arturk E, Gunaydin M, Gurses N. Congenital lumbar hernia associated with the lumbocostovertebral syndrome: two cases. Eur J Pediatr Surg 1997;7:122-124.

  9. 9. Hancoock BJ, Wiseman NE. Incarcerated congenital lumbar hernia associated with the lumbocostovertebral syndrome. J Pediatr Surg 1988;23:782-783.

  10. 10. Swartz WT. Lumbar hernias. J Ky Med Assoc 1954;52:673-678.

  11. 11. Florer RE, Kiriluk L. Petit’s triangle hernia, incarcerated: two case reports. Am Surg 1971;37:527-530.

  12. 12. Goodman EH, Speese J. Lumbar hernia. Ann Surg 1916;63:548.

  13. 13. Watson. Hernia. 3rd ed. St. Louis: CV Mosby;1948. pp. 443-455.

  14. 14. Prabhakar SA, Iyer SP, Nagarajan G, Gore MA, Alaspurkar S. A case of bilateral irreducible lumbar hernia causing intestinal obstruction. Available in http://www.edu.rcsed.ac.uk/Case %20Presentations/CP27.htm

  15. 15. Wakhlu A, Wakhlu AK. Congenital lumbar hernia. Pediatr Surg Int 2000;16:146.

  16. 16. Fakhry SM, Azizkhan RG. Observations and current operative management of congenital lumbar hernias during infancy. Surg Gynecol Obstet 1991;172:475.

  17. 17. Pul M, Pul N, Gurses N. Congenital lumbar (Grynfellt-Lesshaft) hernia. Eur J Pediatr Surg 1991;1:115:117.

  18. 18. Baker ME, Weinerth JL, Andriani RT, Cohan RH, Dunnick NR. Lumbar hernias: diagnosis by CT. AJR 1987;148:565-567.

  19. 19. Weschler RJ, Kurtz AB, Needleman L, et al. Cross sectional imaging of abdominal wall hernias. AJR 1989;153:517-521.

  20. 20. Siffring PA, Forest TS, Frick MP. Hernias of the inferior lumbar space: diagnosis with US. Radiology 1989;170 (pt 1):190.

  21. 21. Selby CD. Direct abdominal hernia of traumatic origin. JAMA 1906;47:1485.

  22. 22. Baeza-Herrera C, Franco-Vázquez R. Hernia del triángulo de Grynfellt. Presentación de dos casos. Bol Med Hosp Infant Mex 1985;42:329-331.

  23. 23. Hafner CD, Wylie JH, Brush BE. Petit’s lumbar hernia: repair with Marlex mesh. Arch Surg 1963;86:180.

  24. 24. Lichtenstein IL. Repair of large diffuse lumbar hernias by an extraperitoneal binder technique. Am J Surg 1986;151:501-504.

  25. 25. Fakhry SM, Azizkhan RG. Observations and current operative management of congenital lumbar hernias during infancy. Surg Gynecol Obstet 1991;172:475-479.

  26. 26. Lau H, Lee F. Mesh plug hernioplasty of superior lumbar hernia. Ann Coll Surg Hong Kong 2006;1:25-27.

  27. 27. Bickel A, Haj M, Eitan A. Laparoscopic management of lumbar hernia. Surg Endosc 1997;11:1129-1130.

  28. 28. Burick AJ, Parscandola SA. Laparoscopic repair of a traumatic lumbar hernia: a case report. J Laparoendosc Surg 1996;6:259.

  29. 29. Arca MJ, Heniford BT, Pokorny R, et al. Laparoscopic repair of lumbar hernias. J Am Coll Surg 1998;187:147.

  30. 30. Shekarriz B, Graziottin TM, Gholami S, et al. Transperitoneal preperitoneal laparoscopic lumbar incisional herniorrhaphy. J Urol 2001;166:1267-1269.

  31. 31. Gersin KS. Repair of unusual (lumbar, obturator, and spigelian) abdominal hernias. Problems General Surg 2002;19:84-90.




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