Journal Article•
Grynfeltt-Lesshaft hernia.
02 Apr 2012-Annals of Gastroenterology (The Hellenic Society of Gastroenterology)-Vol. 25, Iss: 1, pp 64-64
TL;DR: A 76-year-old woman presented with a painful growing mass on her left lower back since 10 months, which had become worse during the last 10 days.
Abstract: A 76-year-old woman presented with a painful growing mass on her left lower back since 10 months. The pain was intermittent, but had become worse during the last 10 days. No history of previous procedures and trauma was reported. Physical examination showed a left lumbar tender mass which
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TL;DR: The Sandwich technique has demonstrated good outcomes in the management of the Grynfelt-Lesshaft's hernia and should be according to the classification proposed and to the experience of the surgeon.
Abstract: Introduction Lumbar hernia account for less than 2% of al abdominal hernias, been the Grynfelt-Lesshaft's hernia (GLH) more frequent than the others. With approximately 300 cases published in the literature, the general surgeon may have the chance of treat it ones in their professional life. Case report A 42-years old male with human immunodeficiency virus and Diabetes Mellitus presented to the outpatient clinic with a GLH. Preoperative classified as a type “A” lumbar hernia an open approach was scheduled. We performed a Sandwich technique with a sublay and onlay ULTRAPRO® mesh fixed with PDS® II suture without complications and discharged the patient 24-h after. After six months, the patient denied any complication. Discussion Primary (spontaneous) lumbar hernias represent 50–60% of all GLH. The preoperative classification of a lumbar hernia is mandatory to propose the best surgical approach. According to the classification of Moreno-Egea A et al., the best technique for our patient was an open approach. The Sandwich technique has demonstrated good outcomes in the management of the GLH. Conclusion The surgical approach should be according to the classification proposed and to the experience of the surgeon. The Sandwich technique has good outcomes.
15 citations
TL;DR: In this paper, the authors presented a case of successful detection of a Grynfeltt-Lesshaft hernia by US scan then confirmed by a subsequent CT scan, the aim of this case report was to Increase knowledge of lumbar hernias and to demonstrate the role of US in the diagnosis of LBS.
Abstract: Grynfeltt-Lesshaft hernia is a type of lumbar hernia located in the superior lumbar triangle. Lumbar hernias are rare hernias. Clinical diagnosis of lumbar hernias can be a challenging especially in obese or asymptomatic patients. Lumbar hernias have been frequently misdiagnosed and lead to serious complications. Surgery (open or laparoscopic) is recommended to correct the defect and to avoid the exacerbation of the hernia and associated complications. The majority of the reported cases in the past were diagnosed on a CT scan. This study presents a case of successful detection of a Grynfeltt-Lesshaft hernia by US scan then confirmed by a subsequent CT scan. The aim of this case report was to Increase knowledge of lumbar hernias and to demonstrate the role of US in the diagnosis of lumbar hernias.
1 citations
30 Apr 2019
TL;DR: A 70-year-old male patient with previous trauma in the lumbar region 30 years ago and since then presented as a tumor in that region was diagnosed as a lipoma, but then Grynfeltt's hernia was identified and properly repaired.
Abstract: Lumbar hernia is a disease that presents unsual and difficult diagnosis. It is most prevalent in males and the elderly. It is presented the case of a 70-year-old male patient with previous trauma in the lumbar region 30 years ago and since then presented as a tumor in that region. He asked for a medical help and, initially, his case was diagnosed as a lipoma, but then Grynfeltt's hernia was identified and properly repaired. Keywords: Lumbar hernia; Grynfeltt hernia; superior lumbar hernia
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TL;DR: The clinical symptoms and signs usually allow for easy diagnosis and excision of the sac and high ligation, followed by repair using either surrounding tissue or prosthetic material, provided satisfactory results.
Abstract: Background. Lumbar hernia is a relatively rare phenomenon. The aim of this study was to investigate the clinical manifestation, the diagnosis of lumbar hernia, and the outcome of the surgical procedure. Methods. Eleven cases of lumbar hernia were studied by clinical observation retrospectively from July 1998 to July 2000. Results. All the patients were diagnosed clinically and confirmed operatively. The typical manifestation was a semi-spherical painful mass in the superior or inferior triangle. If the gut was incarcerated, bowel obstruction may subsequently develop. Ten of the eleven patients were treated successfully. Conclusions. The clinical symptoms and signs usually allow for easy diagnosis. Excision of the sac and high ligation, followed by repair using either surrounding tissue or prosthetic material, provided satisfactory results.
68 citations
"Grynfeltt-Lesshaft hernia." refers background in this paper
...Back lumbar hernias are rare wall defects of the lumbar area [1-3], a region bound by the external oblique muscle laterally, the erector spinae muscle medially, the iliac crest inferiorly and the 12th rib superiorly [1,2]....
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...Clinically, they may present from asymptomatic to painful masses, usually reducible and exercise-related [3]....
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...The region is divided into two spaces, the superior one known as Grynfeltt-Lesshaft’s triangle, and the inferior space, also called Petit’s triangle [1-3]....
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...Even though the diagnosis is clinical, CT imaging study is broadly recommended [1-3]....
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TL;DR: The anatomy of the two orifices of the abdominal posterior wall where lumbar hernias could appear are described and a correct surgical treatment permitted a quick recovery.
Abstract: 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). 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. 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. Thanks to clinical and anatomical knowledge, these rare superior lumbar hernias were diagnosed and a correct surgical treatment permitted a quick recovery.
53 citations
"Grynfeltt-Lesshaft hernia." refers background in this paper
...Back lumbar hernias are rare wall defects of the lumbar area [1-3], a region bound by the external oblique muscle laterally, the erector spinae muscle medially, the iliac crest inferiorly and the 12th rib superiorly [1,2]....
[...]
...Grynfeltt-Lesshaft hernias are more common [1], as the superior triangle is larger [2]....
[...]
...The region is divided into two spaces, the superior one known as Grynfeltt-Lesshaft’s triangle, and the inferior space, also called Petit’s triangle [1-3]....
[...]
...Even though the diagnosis is clinical, CT imaging study is broadly recommended [1-3]....
[...]
TL;DR: The impression, however, is that the open approach, with a small lumbotomy, seems to be easy, safe and presents good postoperative recovery.
Abstract: Back 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 primary lumbar hernia. A general surgeon will have the opportunity to repair only one or a few lumbar hernia cases in his/her lifetime. We report a case of a healthy 50-year-old man, with no previous surgeries or history of trauma, who presented to the outpatient department with abdominal discomfort, pain, and a sensation of a growing mass on his lower left back for 4 years. CT scan of the abdomen showed a mass in the left posterolateral abdominal wall. Specifically, a herniation of retroperitoneal fat between the erector spinae muscle group and internal oblique muscles through aponeurosis of the transversalis muscle (Grynfeltt hernia). The patient underwent a small lumbotomy, polypropylene mesh was placed and he recovered well. Although many techniques have been described for the surgical management of such hernias, none of them can be recommended as the preferred method. Our impression, however, is that the open approach, with a small lumbotomy, seems to be easy, safe and presents good postoperative recovery.
27 citations