Journal List > J Korean Surg Soc > v.77(2) > 1010998

TOOLS
Park, Hur, Kim, and Kim: Recurrence after Repair of Primary Acquired Grynfeltt Hernia
Case Report
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2009; 77(2): 149-152.

Published online: 4 August 2009

DOI: https://doi.org/10.4174/jkss.2009.77.2.149

Recurrence after Repair of Primary Acquired Grynfeltt Hernia

Chan Yong Park, M.D., Young Hoe Hur, M.D., Jung Chul Kim, M.D., Shin Kon Kim, M.D.

Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.

Corresponding author (wkafyddl@hanmail.net)

Received 10 February 2009       Accepted 23 February 2009

Copyright © 2009 The Korean Surgical Society

Abstract

Lumbar hernias are rare posterolateral abdominal wall defects. There are two types of lumbar hernia. One is a superior lumbar hernia through the deep superior orifice (Grynfeltt triangle), and the other is a lower lumbar hernia through the superficial lower orifice (Petit triangle). A lumbar hernia is often misdiagnosed as a lipoma, so a cautious clinical examination is very important. Reports of recurrent lumbar hernia are extremely rare in the literature. We experienced a case of recurrence in an acquired primary lumbar hernia in a 71-year-old male who had undergone mesh-plug herniorrhaphy. The hernia orifice was 1 cm in diameter and exhibited a fibrous smooth margin. Hernia repair using 3-D mesh was performed. The patient had uncomplicated postoperative course and was discharged one day after the operation.

Keywords: Lumbar hernia, Grynfeltt triangle, Recurrence, Acquired primary, 3-D mesh

Figures and Tables

Fig. 1
Radiologic findings. (A) Ultrasonogram shows a 2.6 cm sized movable mass with marked posterior acoustic shadow. (B) Abdominal MRI reveals a 3.7×2.6×6.3 cm sized herniated retroperitoneal fat through the defect of transversalis fascia (arrow) at the level of L2~L3.
jkss-77-149-g001
Fig. 2
Operative findings. (A) After skin incision, a displaced mesh plug is exposed. (B) The size of facial defect is about 1 cm of diameter. (C) Onlay of Prolene* 3D patch® (Ethicon, Somerville, NJ, USA) covered more than 3 cm from the margin of facial defect in all directions.
jkss-77-149-g002

References

1. Skrekas G, Stafyla VK, Papalois VE. A Grynfeltt hernia: report of a case. Hernia. 2005. 9:188–191.
2. Heniford BT, Iannitti DA, Gagner M. Laparoscopic inferior and superior lumbar hernia repair. Arch Surg. 1997. 132:1141–1144.
3. Le Neel JC, Sartre JY, Borde L, Guiberteau B, Bourseau JC. Lumbar hernias in adults. Apropos of 4 cases and review of the literature. J Chir (Paris). 1993. 130:397–402.
4. Armstrong O, Hamel A, Grignon B, NDoye JM, Hamel O, Robert R, et al. Lumbar hernia: anatomical basis and clinical aspects. Surg Radiol Anat. 2008. 30:533–537. discussion 609-10.
5. Loukas M, El-Zammar D, Shoja MM, Tubbs RS, Zhan L, Protyniak B, et al. The clinical anatomy of the triangle of Grynfeltt. Hernia. 2008. 12:227–231.
6. Park HR, Baek SK, Lee TS, Bae OS, Park SD. Lumbar hernia combined with descending colon incarceration. J Korean Surg Soc. 2006. 71:482–485.
7. Salemis NS, Nisotakis K, Gourgiotis S, Tsohataridis E. Segmental liver incarceration through a recurrent incisional lumbar hernia. Hepatobiliary Pancreat Dis Int. 2007. 6:442–444.
8. Zhou X, Nve JO, Chen G. Lumbar hernia: clinical analysis of 11 cases. Hernia. 2004. 8:260–263.
9. Cavallaro G, Sadighi A, Miceli M, Burza A, Carbone G, Cavallaro A. Primary lumbar hernia repair: the open approach. Eur Surg Res. 2007. 39:88–92.
TOOLS
Similar articles