Lumbar hernia. Case report and literature review

Background. 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 congenital lumbar hernia. Case Report. We present the case of a patient with congenital lumbar hernia and a review describing the regional anatomy, laparoscopic techniques as a surgical alternative, and the impact of modern imagenology in diagnosis, confirmation and demarcation of the aponeurotic defect, in order to update information and to provide the surgeon with the tools for optimal perioperative preparation and the best operative technique for this rare disease. We describe here the case of a 5-month-old Mexican female infant with a right lumbar bulging. Ultrasonographic findings showed an aponeurotic defect and an ipsilateral renal agenesia. Open surgical repair was carried out with identification of the defect in the superior or Grynfellt-Lesshaft's triangle and the inferior triangle as well. A polypropylene mesh was placed below the posterior abdominal sheath. Conclusions. Congenital lumbar hernia usually originates in the superior triangle or Grynfellt-Lesshaft's triangle and is frequently associated with lumbocostovertebral syndrome. Surgery is always indicated, with utilization of prosthetic material or muscular flaps as the best repair technique.