<p>Primary superior lumbar hernia፡ a rare cause of lumbar swelling</p>

Abstract

Background Superior lumbar hernia is a rare posterolateral abdominal wall defect and herniation of abdominal contents through the superior lumbar triangle. A lumbar hernia is an unusual defect and only 300 cases of primary lumbar hernias have been reported since the first case report in 1731. To date, most clinicians are usually unfamiliar with the presentation of lumbar hernias, and the diagnosis is often done in a wrong way. Case report A 55-year-old female patient presented with complaints of right flank pain and swelling on the right lumbar region. On abdominal examination, there was round protruding swelling immediately beneath the 12 th rib of the right upper flank area. The swelling was palpable and bowel sound was heard over it. The swelling was easily reducible and protruded when the patient was coughing or straining. The opposite side of the lumbar region was normal, and chest examination was clear and normal. The hematological and urine analysis laboratory findings were normal. Discussion The ultrasound finding revealed the bowel contents within the hernial sac. With the diagnosis of primary acquired superior lumbar hernia, the patient underwent open surgery. The defect was reduced back and repaired using a retro-muscular or sublay prolene mesh (15 cm by 7.5 cm). The patient was discharged at post-operative day four and followed-up for four months. Conclusion In conclusion, the diagnosis of lumbar hernias should be considered in all patients presented with complaints of flank pain and swelling in the flank area. In the absence of obvious swelling in the flank region, ultrasound investigation might not establish the diagnosis of lumbar hernias. Hence, ultrasound would be the option to confirm the diagnosis when the swelling is palpable.

Identifying the Hernial Orifice in Superior Lumbar Hernia Repair by Utilizing Anatomical Landmarks on Preoperative CT

“…CT scan is essential in defining hernia contents accurately [4]. However, ultrasonography and MRI may not diagnose LH without an obvious bulge in the flank region [7].…”

Spontaneous Lumbar Hernia: A Case Report

“…The laparoscopic can either be extraperitoneal or transabdominal. Both laparoscopic and open repair have similar success rates with trends favouring the laparoscopic approach due higher accuracy in precisely locating and evaluating the characteristics of the defect, shorter hospital stay, reduced infection rates, and reduced analgesics requirement (7)(8)(9)(10). The closure of the defect can be done by direct closure of the defect or with an additional prosthetic mesh.…”

Renal pelvis and ureteropelvic junction incarceration in a Grynfeltt-Lesshaft hernia: a case report and review of the literature

“…A lumbar hernia is an unusual defect, and only 300 cases of primary lumbar hernias have been reported since the first case report by Garangoet in 1731 [13,14,16]. Their diagnosis is vital due to their substantial possible complications such as incarceration and strangulation in 25 and 8% of patients retrospectively [17].…”