Hérnia lombar encarcerada complicada com obstrução intestinal e perfuração de ceco

Abstract

Lumbar hernia is defined as an abdominal passage through the posterior abdominal wall. Approximately 250 to 300 cases have been described in the literature, being quite infrequent. Untreated lumbar hernia may result in severe complications. The authors report a case of a 60 year old male patient presenting a large bowel obstruction and perfuration secundary to incarceration of descending colon within a lumbar hernia. This was diagnosed by clinical history and computed tomography. The patient was successfully treated surgically.

Clinical And Surgical Anatomy Of Lumbar Hernia: A Review

“…Acquired lumbar (HLA) or primary hernias arise in physiologically fragile anatomical regions of the posterior abdominal wall (PAP) [1,2] Such regions are identified as upper lumbar triangle or of Grynfelt-Lesshaft and lower lumbar triangle or of Jean Louis Petit, both present in the body antimeres [2,3]. Other non-specific regions for the appearance of HLAs are surgical or post-traumatic scars that, for some reason, have resulted in points of extreme fragility of PAP [4,5].…”

“…The muscular and connective structures that confer resistance to this region have well defined and distinct forms, due to this, not all PAP layers are present in their full extent, having regions less thick than others [9,10]. In addition, in these regions there are gaps in the abdominal wall that give passage to the posterior branches of the lumbar nerves and blood vessels [2]. These added factors give rise to regions of PAP fragility susceptible to the appearance of herniations [1,2,10].…”

“…In addition, in these regions there are gaps in the abdominal wall that give passage to the posterior branches of the lumbar nerves and blood vessels [2]. These added factors give rise to regions of PAP fragility susceptible to the appearance of herniations [1,2,10].…”

“…The superior lumbar triangle or Grynfelt-Lesshaft is a region of posterolateral fragility delimited superiorly by the lower border of the 12 th rib and by the posterior serratus muscle, laterally by the internal oblique muscle and medially by the quadratus lumbar muscle [1,2,4,6]. Superficially, this region is covered by the great dorsi muscle and its floor is formed by the aponeurosis of the transverse abdominis muscle [1,4,6,10].…”