Varban Oliver
University of Michigan Health Systems, 2210 Taubman Center, 1500 E Medical Center Drive, SPC 5343, Ann Arbor, MI 48109-5343, United States.
Int J Surg Case Rep. 2013;4(10):869-71. doi: 10.1016/j.ijscr.2013.06.008. Epub 2013 Jun 25.
Lumbar hernia is a rare complication that can occur after breast reconstruction using a latissimus dorsi flap. The defect occurs within the superior lumbar triangle and may result in visceral incarceration.
We report a 61-year-old female who presented with a left sided lumbar bulge and pain 7 years following a modified radical mastectomy and latissimus dorsi flap reconstruction. Computed tomography demonstrated a lumbar hernia with incarcerated colon. The patient underwent a successful laparoscopic repair with prosthetic mesh underlay.
Lumbar hernias may be congenital, secondary to trauma or prior surgery. Imaging studies assist in excluding soft tissue tumors, infections, hematoma or abdominal wall denervation atrophy, which may also present as a lumbar bulge. Repair may be performed in an open, laparoscopic or retroperitoneoscopic approach.
Laparoscopic lumbar hernia repair with mesh is a safe and feasible way to manage an uncommon complication after breast reconstruction with a latissimus flap.
腰疝是使用背阔肌肌皮瓣进行乳房重建术后可能出现的一种罕见并发症。该缺损发生于腰上三角内，可能导致内脏嵌顿。
我们报告一名61岁女性，在改良根治性乳房切除术后并采用背阔肌肌皮瓣重建7年后，出现左侧腰部肿块及疼痛。计算机断层扫描显示为腰疝伴结肠嵌顿。患者接受了成功的腹腔镜修补术，采用人工补片衬于下方。
腰疝可能是先天性的，继发于创伤或既往手术。影像学检查有助于排除也可能表现为腰部肿块的软组织肿瘤、感染、血肿或腹壁去神经萎缩。修补可采用开放、腹腔镜或后腹腔镜入路进行。
腹腔镜下使用补片修补腰疝是处理背阔肌肌皮瓣乳房重建术后罕见并发症的一种安全可行的方法。
