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| 篇名 |
The lumbar hernia: A clinical conundrum |
| 作者 |
Abhishek Dagar, Naman Hurria, Saurabh Chandrakar, Manjit Tanwar*, Sandhya Gupta, Ajit Sinha |
| 卷期/出版年月 |
55卷6期 (2022/11) |
| 頁次 |
234-237 |
| 摘要 |
Lumbar hernias are rarely encountered as compared to other ventral abdominal wall hernias and are often
misdiagnosed and overlooked. They account for less than 1.5% of all abdominal hernias. Fewer than 300 cases
have been reported over the past 300 years. A lumbar hernia is defined as a protrusion of intra-abdominal
contents through a weakness or rupture in the posterior abdominal wall. It must be distinguished from a
lipoma, cold (tuberculous) abscess or a pseudo-hernia due to local muscular paralysis. Presenting a case of
65-year-old female who came to surgery OPD with complaint of a swelling in the right lumbar area since 5
years. On examination, a smooth and non-tender swelling measuring approximately 4 x 3 cm was evident
in right lumbar region. We proceeded with a lumbar ultrasound which confirmed the presence of the hernia
in posterior abdominal wall. Later, the patient was admitted for surgery under spinal anaesthesia. An open
approach was performed and intraoperative findings revealed retroperitoneal fat, intermuscular lipoma
and a small hernia sac as contents of swelling. It is very unusual to find lumbar hernias presenting with a
lipoma, as in our case, the clinical findings alone can be very confusing and increase the chances of incorrect
diagnosis and subsequent treatment. Inability of clinical examination and ultrasonography alone in making
an adequate diagnosis of lumbar hernia in preoperative setting mandates a routine CT/MRI for all such
patients, to ensure surgeons have a correct diagnosis before proceeding for surgery. Ideal management is
just like other hernias, i.e., with mesh hernioplasty either laparoscopically or through an open approach. |
| 關鍵詞 |
Lipoma, lumbar hernia, rare |
| 分類 |
Case Report |
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