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.

A Case of Congenital Lumbar Hernia / 대한소아소화기영양학회지

An lumbar hernia is a rare clinical disease entity thatarises from the superior or inferior lumbar triangle and presents as a reducible protruding mass in the flank region between twelfth rib and the iliac crest. There are two classifications one classification is a congenital or acquired hernia according to the occurrence timing and the other classification is a superior (Grynfeltt-Lesshaft hernia) or inferior (Petit's hernia) lumbar hernia according to the anatomical location. Approximately 10% of all lumbar hernias are congenital and the vast majority of them are unilateral. We report here a case of a congenital lumbar hernia through the superior lumbar triangle of Grynfeltt-Lesshaft without any other congenital anomalies or complications in a four-month-old male. It was treated successfully with a surgical repair.

2 Cases of Lumbar Hernia

Lumbar hernia presents as a reducible protruding mass in the flank region between the 12th rib and the iliac crest. The superior lumbar hernia (Grynfeltt's) is covered by the thin latissimus dorsi muscle and bounded by the erector spinae and internal obliquus abdominis muscle. The lumbodorsal fascia forms the floor of the Grynfeltt's triangle. Spontaneous or acquired non-traumatic lumbar hernia occurs more frequently after middle age. The untreated lumbar hernia progresses in size gradually. As in most hernias, the larger the defect, the more complicated and difficult is the repair. Here we report 2 female patients with spontaneous lumbar hernia diagnosed at Presbyterian Medical Center with computerized tomogram. Their treatment consisted of tension-free surgical repair utilizing the overlap method for defect edge and the application of prolene mesh.