Grynfelt hernia: case report and literature review.
Back lumbar hernia is a rare abdominal wall defect that usually presents spontaneously after trauma or lumbar surgery or, less frequently, during infancy (congenital). Few reports have been published in the literature describing primary lumbar hernia. A general surgeon will have the opportunity to repair only one or a few lumbar hernia cases in his/her lifetime. We report a case of a healthy 50-year-old man, with no previous surgeries or history of trauma, who presented to the outpatient department with abdominal discomfort, pain, and a sensation of a growing mass on his lower left back for 4 years. CT scan of the abdomen showed a mass in the left posterolateral abdominal wall. Specifically, a herniation of retroperitoneal fat between the erector spinae muscle group and internal oblique muscles through aponeurosis of the transversalis muscle (Grynfeltt hernia). The patient underwent a small lumbotomy, polypropylene mesh was placed and he recovered well. Although many techniques have been described for the surgical management of such hernias, none of them can be recommended as the preferred method. Our impression, however, is that the open approach, with a small lumbotomy, seems to be easy, safe and presents good postoperative recovery.
Cesar
D
D
Department of Surgery, Bonsucesso General Hospital, National Health Institute, 616 Londres Avenue, Rio de Janeiro, RJ 21041-030, Brazil. danielcesar@live.com
Valadão
M
M
Murrahe
R J
RJ
D034861:Abdominal Wall / Q000601:surgery*; D046449:Hernia, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D008161:Lumbosacral Region / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013526:Surgical Mesh; D014057:Tomography, X-Ray Computed
Arch Surg. 2007 Jan;142(1):82-8
17224505
J Am Coll Surg. 1998 Aug;187(2):147-52
9704960
Arch Surg. 1963 Feb;86:180-6
13951839
Surg Endosc. 2005 Feb;19(2):184-7
15573242
Arch Surg. 1997 Oct;132(10):1141-4
9336516
South Med J. 2000 Nov;93(11):1067-9
11095553
AJR Am J Roentgenol. 2000 May;174(5):1413-5
10789805
Ann Surg. 1971 Feb;173(2):294-7
5541485
Abdom Imaging. 1995 Sep-Oct;20(5):446-8
7580781
Int Braz J Urol. 2005 Jul-Aug;31(4):309-14
16137398
JSLS. 2004 Oct-Dec;8(4):391-4
15554289