J Korean Surg Soc.  2009 Sep;77(3):221-224. 10.4174/jkss.2009.77.3.221.

Post-traumatic Lumbar Hernia Repaired with PHS (Prolene Hernia System)

• Chung M

• KMID: 2004224
• DOI: http://doi.org/10.4174/jkss.2009.77.3.221

Abstract

Lumbar hernia is a rare disease. Only five papers on lumbar hernia are found in the Journal of the Korean Surgical Society. Lumbar hernia is an extrusion of intraperitoneal or extraperitoneal organs of the abdomen through a defect of the transversalis fascia or the transversus abdominis muscle aponeurosis in the posterolateral abdominal wall. The most frequent symptom of this hernia is a protruding mass at the lateral abdominal wall with increased abdominal pressure. I encountered a case of lumbar hernia. The subject fell off of a subway platform. The cervical spine was injured and he suffered from quadriplegia. After several operations, he recovered from the quadriplegia. Following that, he discovered a left lumbar mass, incidentally. CT and MRI revealed this mass to be a Grynfeltt's hernia. This hernia was corrected by open method with PHS. There were no complications or discomfort after the operation. I report this case with a review of the literature.

Keyword

Lumbar hernia; PHS; Grynfeltt's hernia

MeSH Terms

Abdomen
Abdominal Wall
Fascia
Hernia
Herniorrhaphy
Hydrogen-Ion Concentration
Muscles
Quadriplegia
Railroads
Rare Diseases
Spine

Figure

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  Fig. 1 CT findings of lumbar hernia. Defect (arrows) is shown between quadratus lumborum muscle and internal oblique muscle This finding means this defect is Gynfeltt's lumbar hernia.

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  Fig. 2 Operation findings of lumbar hernia. Fat is protruded through defect (B). There is a 1 cm in diameter- sized defect after reduction (A). Line on left side is costal margin and line on right side is iliac crest.

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  Fig. 3 Operation field after insertion of PHS (prolene hernia system). Onlay is removed and four stitches are applied to fix the PHS. Line on left side is costal margin and Line on right side is iliac crest.

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  Fig. 4 PHS (medium size). PHS has three components; onlay, underlay and connector.

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