Sciatic hernia: a comprehensive review of the world literature (1900–2008)

Losanoff, Julian E.; Basson, Marc D.; Gruber, Scott A.; Weaver, Donald W.

doi:10.1016/j.amjsurg.2009.02.009

“…The origin of these hernias is the sciatic foramen, which is demarcated by the sacrospinous ligament. A sciatic hernia is more often found in women; one-third of these women are ≥60 years of age [1]. Identifying the nature of the condition by examining the symptoms is often challenging.…”

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confidence: 99%

A Giant Sciatic Hernia

Kostov

¹

,

Kostov

²

2017

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A sciatic hernia rarely occurs; hence, clinicians often face difficulties in making a diagnosis. The origin of these hernias is the sciatic foramen, which is demarcated by the sacrospinous ligament. A sciatic hernia is more often found in women; one-third of these women are ≥60 years of age [1]. Identifying the nature of the condition by examining the symptoms is often challenging. Half of the patients give a qualitative account of their condition; this consists of them having non-specific abdominal and pelvic pain and one-third of them having a tumor identified in their clinical examination. Ultrasonography and computed tomography are the standard imaging modalities used to diagnose sciatic hernias; however, it is worth mentioning that magnetic resonance imaging (MRI) can also be used for patients where entrapment of the sciatic nerve is suspected. A 52-year-old man who reported having abdominal pain along with a giant mass in the left perineum and left buttock was admitted to our hospital (Figure 1). Figure 2 shows an MRI scan of a sciatic hernia located on the left side with a large hernial sac full of omentum. Laparotomy was performed, and it revealed that the greater omentum protruded from the left sciatic foramen. The omentum, which was jutting out, was reduced by traction, thus avoiding resection as ischemia was absent. Reparation of the sciatic foramen defect was done by suturing the edges. The patient was discharged from the hospital on the fifth postoperative day.There is no standardized surgical procedure for correcting sciatic hernias; hence, abdominal, gluteal, and combined approaches have been described in the literature. The transabdominal approach is preferred in patients where clinicians suspect small bowel incarceration or strangulation.Ethics Committee Approval: Ethics committee approval was received for this study from the ethics committee of the Naval Hospital (No. 2017-16).Informed Consent: Written informed consent was obtained from patient who participated in this study.Peer-review: Externally peer-reviewed. Eurasian J Med 2017; 49: 222-3.

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“…Sciatic hernia may present as a gluteal mass or with complications of the pelvis content (2)(3)(4). This content may be small intestine (obstruction), ureter and bladder (infection and obstruction), ovaries and fallopian tubes (pelvic pain), colon, omentum and Meckel's diverticulum (1). Sciatica occurs as a result of compression of the sciatic nerve by the herniated sac (1)(2)(3)(4)(5).…”

Section: Discussionmentioning

confidence: 99%

“…This content may be small intestine (obstruction), ureter and bladder (infection and obstruction), ovaries and fallopian tubes (pelvic pain), colon, omentum and Meckel's diverticulum (1). Sciatica occurs as a result of compression of the sciatic nerve by the herniated sac (1)(2)(3)(4)(5). To our knowledge, four well-documented descriptions of a lipoma herniating through the sciatic foramen have been reported, and it was first defined in 1964 (3, 4, 6, 7).…”

Section: Discussionmentioning

confidence: 99%

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A giant retroperitoneal lipoma presenting as a sciatic hernia: MRI findings

Duran

¹

,

Çavuşoğlu

²

,

Elverici

³

et al. 2015

Journal of the Belgian Society of Radiology

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“…A surgical review of sciatic hernias described 99 cases occurring between 1900 and 2008 [1]. Sciatic hernias have been described containing various gastrointestinal and genitourinary structures, including small bowel, omentum, Meckel's diverticulum, colon, ovary, fallopian tube, bladder, and ureter [2,3].…”

Section: Discussionmentioning

confidence: 99%