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Published in: Surgical and Radiologic Anatomy 7/2008

01-10-2008 | Original Article

Lumbar hernia: anatomical basis and clinical aspects

Authors: O. Armstrong, A. Hamel, B. Grignon, J. M. NDoye, O. Hamel, R. Robert, J. M. Rogez

Published in: Surgical and Radiologic Anatomy | Issue 7/2008

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Abstract

Introduction

The purpose of this study was to describe the anatomy of the two orifices of the abdominal posterior wall where lumbar hernias could appear. They may protrude through the superficial lumbar triangle (JL Petit) or the deepest superior orifice (Grynfeltt).

Methods

The exact limits were precised by dissections in cadavers to explain the main differences of these two locations. We report two cases of spontaneous lumbar hernias discovered in outpatient clinic.

Results

Clinical diagnosis was difficult and both the patients were sent for lumbar lipoma but a meticulous examination gave us a clue. MRI was useful to confirm the defect in the posterior abdominal wall under the 12th rib. Only one patient was operated by a direct approach with a reinforcement of an unabsorbable mesh. No recurrence appeared during follow-up.

Conclusion

Thanks to clinical and anatomical knowledge, these rare superior lumbar hernias were diagnosed and a correct surgical treatment permitted a quick recovery.
Literature
1.
go back to reference Alexandre JH, Bouillot JL (1994) Traitement chirurgical des hernies lombaires. Editions techniques. EMC (Paris France) Techniques chirurgicales Appareil digestif, pp 40–152 Alexandre JH, Bouillot JL (1994) Traitement chirurgical des hernies lombaires. Editions techniques. EMC (Paris France) Techniques chirurgicales Appareil digestif, pp 40–152
2.
go back to reference Astarcioglu H, Sokmen S, Atila K, Karadenir S (2003) Incarcerated inferior lumbar (Petit’s) hernia. Hernia 7:158–160PubMedCrossRef Astarcioglu H, Sokmen S, Atila K, Karadenir S (2003) Incarcerated inferior lumbar (Petit’s) hernia. Hernia 7:158–160PubMedCrossRef
3.
go back to reference Biance N, Hardwigsen J, Morera P, Peyrcru T, Le Treut YP (2006) Hernia of Petit’s triangle (lumbar hernia): laparoscopic repair. J Chir 143(3):199–201 Biance N, Hardwigsen J, Morera P, Peyrcru T, Le Treut YP (2006) Hernia of Petit’s triangle (lumbar hernia): laparoscopic repair. J Chir 143(3):199–201
4.
go back to reference Carbonnel AM, Kercher KW, Sigmon L, Matthews BD, Sing RF, Kneisl JS, Heniford BT (2005) A novel technique of lumbar hernia repair using bone anchor fixation. Hernia 9:22–25CrossRef Carbonnel AM, Kercher KW, Sigmon L, Matthews BD, Sing RF, Kneisl JS, Heniford BT (2005) A novel technique of lumbar hernia repair using bone anchor fixation. Hernia 9:22–25CrossRef
5.
go back to reference Cavallaro G, Sadighi A, Miceli M, Burza A, Carbone G, Cavallaro A (2007) Primary lumbar hernia repair: the open approach. Eur Surg Res 39(2):88–92PubMedCrossRef Cavallaro G, Sadighi A, Miceli M, Burza A, Carbone G, Cavallaro A (2007) Primary lumbar hernia repair: the open approach. Eur Surg Res 39(2):88–92PubMedCrossRef
6.
go back to reference Di Carlo I, Toro A, Sparatore F, Corsale G (2007) Lumbar hernia repair using a new technique. Am Surg 73(1):54–57PubMed Di Carlo I, Toro A, Sparatore F, Corsale G (2007) Lumbar hernia repair using a new technique. Am Surg 73(1):54–57PubMed
7.
go back to reference Fogarty JD, Hafron JM, Melman A (2006) Renal obstruction caused by herniation of renal pelvis and ureteropelvic junction through superior triangle hernia (Grynfeltt hernia). Urology 67:620–621PubMedCrossRef Fogarty JD, Hafron JM, Melman A (2006) Renal obstruction caused by herniation of renal pelvis and ureteropelvic junction through superior triangle hernia (Grynfeltt hernia). Urology 67:620–621PubMedCrossRef
8.
go back to reference Grauls A, Lallemand B, Krick M (2004) The retroperitoneoscopic repair of a lumbar hernia of Petit. Case report and review of literature. Acta Chir Belg 104(3):330–334PubMed Grauls A, Lallemand B, Krick M (2004) The retroperitoneoscopic repair of a lumbar hernia of Petit. Case report and review of literature. Acta Chir Belg 104(3):330–334PubMed
9.
go back to reference Guillem P, Czarnecki E, Duval G, Bounouna F, Fontaine C (2002) Lumbar hernia: anatomical route assessed by computed tomography. Surg Radiol Anat 24:53–56PubMedCrossRef Guillem P, Czarnecki E, Duval G, Bounouna F, Fontaine C (2002) Lumbar hernia: anatomical route assessed by computed tomography. Surg Radiol Anat 24:53–56PubMedCrossRef
10.
11.
go back to reference Ipek T, Eyuboglu E, Aydingoz O (2005) Laparoscopic management of inferior lumbar hernia (Petit triangle hernia). Hernia 9:184–187PubMedCrossRef Ipek T, Eyuboglu E, Aydingoz O (2005) Laparoscopic management of inferior lumbar hernia (Petit triangle hernia). Hernia 9:184–187PubMedCrossRef
12.
go back to reference Killen KL, Girard S, De Meo JH, Shanmuganathan K, Mirvis SE (2000) Using CT to diagnose traumatic lumbar hernia. Am J Roentgenol 174:1413–1415 Killen KL, Girard S, De Meo JH, Shanmuganathan K, Mirvis SE (2000) Using CT to diagnose traumatic lumbar hernia. Am J Roentgenol 174:1413–1415
13.
go back to reference Le Neel JC, Sartre JY, Borde L, Guiberteau B, Bourseau JC (1993) Les hernies lombaires de l’adulte. Rapport de 4 observations et revue de la littérature. J Chir 130(10):239–243 Le Neel JC, Sartre JY, Borde L, Guiberteau B, Bourseau JC (1993) Les hernies lombaires de l’adulte. Rapport de 4 observations et revue de la littérature. J Chir 130(10):239–243
14.
go back to reference Loukas M, Tubbs RS, El-Sefdy A, Jester A, Polepalli S, Kinsela C, Wu S (2007) The clinical anatomy of the triangle of Petit. Hernia 11:441–444PubMedCrossRef Loukas M, Tubbs RS, El-Sefdy A, Jester A, Polepalli S, Kinsela C, Wu S (2007) The clinical anatomy of the triangle of Petit. Hernia 11:441–444PubMedCrossRef
15.
go back to reference Madan AK, Ternovits CA, Speck KE, Pritchard FE, Tichansky DS (2006) Laparoscopic lumbar hernia repair. Am Surg 72(4):318–321PubMed Madan AK, Ternovits CA, Speck KE, Pritchard FE, Tichansky DS (2006) Laparoscopic lumbar hernia repair. Am Surg 72(4):318–321PubMed
16.
go back to reference Mgbakor AC, Bami G, Barthe L, Diakite L et al (1999) Les difficultés diagnostiques des hernies lombaires. A propos de 7 cas. Med Afr Noire 46(6):334–336 Mgbakor AC, Bami G, Barthe L, Diakite L et al (1999) Les difficultés diagnostiques des hernies lombaires. A propos de 7 cas. Med Afr Noire 46(6):334–336
17.
go back to reference Moreno-Egea A, Guzman P, Girela E, Corral M, Aguayo Albasini JL (2006) Laparoscopic hernioplasty in secondary lumbar hernias. J Laparoendosc Adv Surg Tech A 16(6):572–576PubMedCrossRef Moreno-Egea A, Guzman P, Girela E, Corral M, Aguayo Albasini JL (2006) Laparoscopic hernioplasty in secondary lumbar hernias. J Laparoendosc Adv Surg Tech A 16(6):572–576PubMedCrossRef
18.
go back to reference Moreno-Egea A, Torralba-Martinez JA, Morales G et al (2005) Open vs. laparoscopic repair of secondary lumbar hernias: a prospective nonrandomized study. Surg Endosc 19:184–187PubMedCrossRef Moreno-Egea A, Torralba-Martinez JA, Morales G et al (2005) Open vs. laparoscopic repair of secondary lumbar hernias: a prospective nonrandomized study. Surg Endosc 19:184–187PubMedCrossRef
19.
go back to reference Naidoo M, Singh B, Ramsaroop L, Satyapal KS (2003) Inferior lumbar triangle hernia: case report. East Afr Med J 80(5):277–278PubMed Naidoo M, Singh B, Ramsaroop L, Satyapal KS (2003) Inferior lumbar triangle hernia: case report. East Afr Med J 80(5):277–278PubMed
20.
go back to reference Okiemy G, Ele N, Mackoumbou-Nkounka A (2006) Hernie lombaire bilatérale du triangle de Petit. A propos d’un cas. Med Afr Noire 53(3):142–144 Okiemy G, Ele N, Mackoumbou-Nkounka A (2006) Hernie lombaire bilatérale du triangle de Petit. A propos d’un cas. Med Afr Noire 53(3):142–144
21.
go back to reference Patten LC, Awad SS, Berger DH, Fagan SP (2004) A novel technique for the repair of lumbar hernias after iliac crest bone harvest. Am J Surg 188:85–88PubMedCrossRef Patten LC, Awad SS, Berger DH, Fagan SP (2004) A novel technique for the repair of lumbar hernias after iliac crest bone harvest. Am J Surg 188:85–88PubMedCrossRef
22.
go back to reference Salemis NS, Nisotakis K, Gourgiotis S, Tsohataridis E (2007) Segmental liver incarceration through a recurrent incisional lumbar hernia. Hepatobiliary Pancreat Dis Int 6(4):442–445PubMed Salemis NS, Nisotakis K, Gourgiotis S, Tsohataridis E (2007) Segmental liver incarceration through a recurrent incisional lumbar hernia. Hepatobiliary Pancreat Dis Int 6(4):442–445PubMed
23.
go back to reference Simon SM et al (2006) Radiology for the surgeon. Can J Surg 49(2):129–130 Simon SM et al (2006) Radiology for the surgeon. Can J Surg 49(2):129–130
24.
25.
Metadata
Title
Lumbar hernia: anatomical basis and clinical aspects
Authors
O. Armstrong
A. Hamel
B. Grignon
J. M. NDoye
O. Hamel
R. Robert
J. M. Rogez
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
Surgical and Radiologic Anatomy / Issue 7/2008
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-008-0361-2

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