Tavares-de la Paz Luis Alberto, Martínez-Ordaz José Luis
Servicio de Gastrocirugía, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social.
Cir Cir. 2007 Sep-Oct;75(5):381-4.
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 congenital lumbar hernia.
We present the case of a patient with congenital lumbar hernia and a review describing the regional anatomy, laparoscopic techniques as a surgical alternative, and the impact of modern imagenology in diagnosis, confirmation and demarcation of the aponeurotic defect, in order to update information and to provide the surgeon with the tools for optimal perioperative preparation and the best operative technique for this rare disease. We describe here the case of a 5-month-old Mexican female infant with a right lumbar bulging. Ultrasonographic findings showed an aponeurotic defect and an ipsilateral renal agenesia. Open surgical repair was carried out with identification of the defect in the superior or Grynfellt-Lesshaft's triangle and the inferior triangle as well, and a polypropylene mesh was placed below the posterior abdominal sheath.
Congenital lumbar hernia usually originates in the superior triangle or Grynfellt-Lesshaft's triangle and is frequently associated with the lumbocostovertebral syndrome. Surgery is always indicated, with utilization of prosthetic material or muscular flaps as the best repair technique.
腰椎疝是一种罕见的腹壁缺损，通常在创伤或腰椎手术后自发出现，或在婴儿期（先天性）较少见。文献中很少有关于先天性腰椎疝的报道。
我们报告一例先天性腰椎疝患者的病例，并综述区域解剖、作为手术替代方案的腹腔镜技术，以及现代影像学在腱膜缺损诊断、确认和划界中的作用，以更新信息并为外科医生提供工具，以便为这种罕见疾病进行最佳的围手术期准备和最佳手术技术。我们在此描述一名5个月大的墨西哥女婴，其右侧腰部膨出。超声检查结果显示腱膜缺损和同侧肾缺如。通过识别上三角或格伦费尔特 - 莱沙夫特三角以及下三角的缺损进行开放手术修复，并在腹后壁鞘膜下方放置聚丙烯网片。
先天性腰椎疝通常起源于上三角或格伦费尔特 - 莱沙夫特三角，且常与腰肋椎综合征相关。手术总是必要的，使用假体材料或肌瓣是最佳修复技术。
