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2009, Number 3

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Rev Mex Cir Pediatr 2009; 16 (3)

Herniated lumbar congenital with involucre renal, associated with syndrome lumbocostovertebral

López-Ibarra S, Garrido-Rodríguez JR, Salinas-Ruiz I, Villagómez-Rosas M, Aguila-Muñoz M

Language: Spanish
References: 25
Page: 140-145
PDF size: 403.29 Kb.


ABSTRACT

Introduction: Of all the herniated abdominal wall, the lumbar are more rare. Have been described less than 300 cases, 10% of which are congenital, from 1802 to 2002, about 45 cases had been publicado, 19 of them in stage neonatal.
Presentation of the case: female patient. The explore it notes lump lumbar later than 10 cm in diameter sent to our hospital diagnosed with hernia vs myelomeningocele. Reaches 5 days of life, it notes lump lumbar later and top left, increases with the crying, approximately 8 x 8 cm. there are also scoliosis. It concludes diagnosis of herniated lumbar congenital later (Grynfeltt-Lesshaft) left. Performed tomography contrasted intravenous corroborating the previous findings, but in addition to observe the handles intestinal and left kidney that protrude the defect of the wall lumbar. Surgery, position prone e transverse incision on the default with extension to column. Dissection of fatty tissue identifying immediately below the default herniario 2 x 3 cm, with the bag and peritoneum which are reduced Currently the patient to 3 years of follow-up without recurrence of the hernia and waiting for the future of correction definitively column.
Discussion: Current have been published about 60 cases with herniated lumbar congenital throughout the world, most in children under 2 years old. In Mexico are 4 previous cases. The etiology is unknown and associates itself with other malformations. The treatment is surgical and recommended do as soon as possible (in the first year of life) to avoid probable complications. Generally, the primary closure is feasible in most cases and, in others it is necessary to use material prosthetic.


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