Traumatic lumbar hernia: CT diagnosis.

Bilateral Lumbar Hernias - A Case Report and An Overview of the Current Literature

“…The commonest contents of a lumbar hernia include retroperitoneal fat, small and large bowel, omentum, caecum, appendix, stomach, ovary, spleen and kidney [15,16]. Nonetheless, these reports include cases of post traumatic or incisional lumbar hernias where the hernial sac may be of substantial size.…”

Traumatic lumbar hernia

“…[4] Clinically, the features of herniation may be missed since these patients have severe intra-abdominal injuries (up to 30%) or other associated injuries, and these may divert the attention away from a hernia that is not grossly apparent. [1][2][3][4][5] However, since CT scan has been the investigation of choice in hemodynamically stable trauma patients who do not require immediate laparotomy, such herniae may be demonstrated well by showing disruption of the musculature, the presence of the intestine in the parietes, and any vascular compromise in addition to the other findings of organ trauma. At times, there may be delayed herniation, and a CT scan taken soon after admission may not show the herniation.…”

“…Traumatic lumbar hernia is such a type of hernia that occurs after blunt trauma and muscle disruption, and arises within the lumbar triangle, bounded by the erector spinae posteriorly, the 12th rib superiorly and the iliac crest inferiorly. [1] The diagnosis can often be missed if one is not aware, since at times, abdominal wall bruising or tenderness may be the only finding, and the presence of other injuries (intra-abdominal or otherwise) tend to draw attention away from the diagnosis. [1][2][3] The present report is to highlight the delay and morbidity that can be associated with such missed diagnosis.…”

“…[1] The diagnosis can often be missed if one is not aware, since at times, abdominal wall bruising or tenderness may be the only finding, and the presence of other injuries (intra-abdominal or otherwise) tend to draw attention away from the diagnosis. [1][2][3] The present report is to highlight the delay and morbidity that can be associated with such missed diagnosis.…”

Appendicular abscess as an unprecedented cause of an inferior lumbar hernia

“…This can lead to significant delay in presentation, which may be detrimental given that bowel incarceration has been reported in 25% and strangulation in 10% of patients. 2 Computed tomography (CT) aids in the diagnosis of ILHs as it shows the breach in the muscular layer and the exact nature of the contents of the hernial sac. A laparoscopic approach is usually successful for smaller defects while the open approach is reserved for larger defects.…”