Traumatic lumbar hernia: A systematic review of the literature / 中华创伤杂志(英文版)

PURPOSE@#Traumatic lumbar hernia (TLH) constitutes a protrusion of content through a defect in the posterior abdominal wall, as a result of injury. This rare entity has been described in limited number of cases.@*METHODS@#A systematic review of the literature was performed according to the meta-analysis of observational studies in epidemiology guidelines. The English literature from 1990 until 2021 was reviewed, using PubMed, EMBASE and Google Scholar bibliographic databases, to identify case reports and case series with patients that were diagnosed with TLH. For each eligible study, demographics, clinical presentation, hernia characteristics, preoperative imaging investigations, operation details, and postoperative data were extracted for assessment. Statistical analysis was performed on SPSS, version 20.0.@*RESULTS@#A total of 62 studies were included for review, with 164 patients with TLH. Mean age was (42.6 ± 14.3) years (47.6% males, 31.1% females, gender not specified in 35 cases). Mean diameter of hernia neck was (6.3 ± 3.1) cm, while the triangles of Petit and Grynfeltt were affected in 74.5% and 14.6%, respectively. Patients diagnosed in the emergency setting account for 54.2%, with CT scan establishing diagnosis in all but one case (97.7%). A delayed diagnosis was made in 45.8%, at a mean 1 year following trauma. Flank bulging (82.8%) and chronic back pain (34.3%) were the most frequent symptoms. In both delayed and acute group, open surgery (63.6% and 92.3%, respectively) was the preferred surgical approach. Postoperative complications were reported in 11.4% of acute and 15.0% of delayed patients. Hernia recurrence was 7%.@*CONCLUSIONS@#TLH is uncommon with 164 cases described since 1990. CT scan is the gold standard in diagnosis. Open surgery is generally the preferred approach, particularly in the emergency setting. Acute TLH can be treated either by primary suture repair or mesh, depending on the local conditions, whereas delayed cases usually require a mesh.

Laparoscopic total extraperitoneal repair of lumbar hernia / 대한외과학회지

Lumbar hernia is a rare surgical entity without a standard method of repair. With advancements in laparoscopic techniques, successful lumbar herniorrhaphy can be achieved by the creation of a completely extraperitoneal working space and secure fixation of a wide posterior mesh. We present a total extraperitoneal laparoendoscopic repair of lumbar hernia, which allowed for minimal invasiveness while providing excellent anatomical identification, easy mobilization of contents and wide secure mesh fixation. A total extraperitoneal method of lumbar hernia repair by laparoscopic approach is feasible and may be an ideal option.

Superior Lumbar Hernia

Lumbar hernia is an uncommon pathological defect of the abdominal wall. It presents difficulties in diagnosis and treatment because of the depth of the sac and the surrounding layers of muscle, fascia, and bone. It is an extrusion of intraperitoneal or extraperitoneal organs of the abdomen through a defect of the transversalis fascia. Inferior lumbar hernias are bordered by the iliac crest representing its base, limited by the external oblique muscle laterally, the latissimus dorsi medially, and the internal oblique muscle as its floor. Superior lumbar hernias are bordered by the 12th rib superiorly, quadratus lumborum muscle medially, and the internal oblique muscle laterally underneath the latissimus dorsi muscle. Diagnosis depends largely on the capacity for clinical suspicion, and confirmation is based on imaging tests. We report a case of an acquired primary lumbar hernia diagnosed by computed tomography, which was treated successfully at our institution.

Hérnia lombar adquirida secundária do tipo Grynfeltt: relato de caso / Acquired secondary Grynfeltt's hernia: a case report

A hérnia lombar é um diagnóstico infrequente e difícil. É mais prevalente em pessoas do sexo masculino e de idade avançada. Relatamos o caso de um paciente de 79 anos de idade, do sexo masculino, que realizou drenagem de derrame pleural há 17 anos e que apresentou quadro clínico e tomográfico de hérnia lombar adquirida secundária do tipo Grynfeltt.

Lumbar hernia is a rare condition whose diagnosis is hardly achieved. The prevalence is higher in elderly men. The present case report describes the case of a male, 78-year-old patient who underwent pleural effusion drainage 17 years before presenting with clinical manifestations and tomographic findings compatible with acquired secondary Grynfeltt's hernia.

Post-traumatic Lumbar Hernia Repaired with PHS (Prolene Hernia System)

Lumbar hernia is a rare disease. Only five papers on lumbar hernia are found in the Journal of the Korean Surgical Society. Lumbar hernia is an extrusion of intraperitoneal or extraperitoneal organs of the abdomen through a defect of the transversalis fascia or the transversus abdominis muscle aponeurosis in the posterolateral abdominal wall. The most frequent symptom of this hernia is a protruding mass at the lateral abdominal wall with increased abdominal pressure. I encountered a case of lumbar hernia. The subject fell off of a subway platform. The cervical spine was injured and he suffered from quadriplegia. After several operations, he recovered from the quadriplegia. Following that, he discovered a left lumbar mass, incidentally. CT and MRI revealed this mass to be a Grynfeltt's hernia. This hernia was corrected by open method with PHS. There were no complications or discomfort after the operation. I report this case with a review of the literature.

Recurrence after Repair of Primary Acquired Grynfeltt Hernia

Lumbar hernias are rare posterolateral abdominal wall defects. There are two types of lumbar hernia. One is a superior lumbar hernia through the deep superior orifice (Grynfeltt triangle), and the other is a lower lumbar hernia through the superficial lower orifice (Petit triangle). A lumbar hernia is often misdiagnosed as a lipoma, so a cautious clinical examination is very important. Reports of recurrent lumbar hernia are extremely rare in the literature. We experienced a case of recurrence in an acquired primary lumbar hernia in a 71-year-old male who had undergone mesh-plug herniorrhaphy. The hernia orifice was 1 cm in diameter and exhibited a fibrous smooth margin. Hernia repair using 3-D mesh was performed. The patient had uncomplicated postoperative course and was discharged one day after the operation.

Superior Lumbar Hernia: A case report

A lumbar hernia is a rare clinical disease entity which arises from the superior or the inferior lumbar triangle. The causes are congenital, traumatic, previous operation, and so on, but spontaneous occurrence is also encountered. We had a occasion to treat a 34-year-old female patient with a left superior lumbar hernia filled with retroperitoneal fats in a sac. The relatively large defect of the transversalis fascia was repaired with a PTFE (polytetrafluoroethylene) graft and an overlying approximation of external oblique and latissimus dorsi muscle. We report on this case with a brief review of the literature.

Superior Lumbar Hernia: A case report

A lumbar hernia is a rare clinical disease entity which arises from the superior or the inferior lumbar triangle. The causes are congenital, traumatic, previous operation, and so on, but spontaneous occurrence is also encountered. We had a occasion to treat a 34-year-old female patient with a left superior lumbar hernia filled with retroperitoneal fats in a sac. The relatively large defect of the transversalis fascia was repaired with a PTFE (polytetrafluoroethylene) graft and an overlying approximation of external oblique and latissimus dorsi muscle. We report on this case with a brief review of the literature.