J Korean Surg Soc.  2009 Aug;77(2):149-152. 10.4174/jkss.2009.77.2.149.

Recurrence after Repair of Primary Acquired Grynfeltt Hernia

• Park CY
• Hur YH
• Kim JC
• Kim SK

• KMID: 2211296
• DOI: http://doi.org/10.4174/jkss.2009.77.2.149

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.

Keyword

Lumbar hernia; Grynfeltt triangle; Recurrence; Acquired primary; 3-D mesh

MeSH Terms

Abdominal Wall
Aged
Hernia
Herniorrhaphy
Humans
Lipoma
Male
Recurrence

Figure

• 

  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.

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  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.

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