Open Surgical Management of Grynfelt-Lesshaft Lumbar Hernia: A Case Report
Main Article Content
Abstract
Introduction: Lumbar hernias are rare defects of the abdominal wall, representing less than 2% of all ventral hernias. Most are located in the Grynfelt-Lesshaft triangle and pose a diagnostic and therapeutic challenge due to their rarity and anatomical variability. Diagnosis is based on physical examination and confirmed by computed tomography, which is considered the gold standard for characterization and surgical planning.
Case report: We present the case of a 63-year-old woman with a history of type 2 diabetes mellitus and well-controlled hypothyroidism, who presented with left dorsolumbar pain of four years’ evolution and a progressive mass in the lumbar region. Computed tomography revealed a posterior wall defect consistent with a left lumbar hernia of the Grynfelt-Lesshaft type. Open surgical repair with placement of a polypropylene mesh was performed under general anesthesia. The postoperative course was satisfactory, with no complications or recurrence during six months of follow-up.
Discussion: Lumbar hernias may be congenital or acquired, and their clinical presentation is variable. Surgical treatment is the gold standard, with both open and laparoscopic approaches proving equally effective when prosthetic reinforcement is used. In this case, open repair was appropriate given the anatomical characteristics of the defect and technical availability. Conclusion: An individualized surgical approach with mesh reinforcement allows for a tension-free, safe, and durable repair. Proper clinical suspicion, imaging diagnosis, and surgical planning are essential to achieve satisfactory functional and aesthetic outcomes.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Barriga, J. C., Padilla, C., Ruiz, J. P., Barrios, A., & Lora, A. (2019). Abordaje laparoscópico de la hernia de Grynfelt: reporte de caso. Revista Médica Sanitas, 22(1), 17–21.
II. Armand Ugón, A., Lorenzelli, A., Galarraga, J., & Aliano, F. (1977). Hernia del espacio de Grynfelt. Cirugía del Uruguay, 47(2), 120–124.
III. Medina Sifuentes, A. M., & Mayagoitia González, J. C. (2018). Apendicitis aguda del anciano dentro de una hernia de Petit: reporte de caso. Revista Hispanoamericana de Hernia, 6(4), 180–182.
IV. López, A. E., Barrionuevo, L. G., & López, F. G. (2024). Hernia lumbar de Grynfelt-Lesshaft. Revista Argentina de Cirugía, 116(3), 233–238.
V. González-Chávez, M. A., Huacuja-Blanco, R. R., & López-Caballero, C. (2014). Contenido inusual del saco herniario: hernias raras o poco comunes. Revista de Investigación Médica Sur México, 21(4), 177–181.
VI. Moreno-Egea, A., & Olalla-Muñoz, J. R. (2014). Doble lesión de pared abdominal: hernia incisional lumbar izquierda y pseudohernia por denervación y atrofia muscular derecha. Manejo laparoscópico conjunto. Revista Hispanoamericana de Hernia, 2(4), 161–168.
VII. Jaén-Oropeza, A. R., Goderich-Lalán, J. M., & Ojeda-López, L. A. (2013). Hernia de Grynfelt: nuestra experiencia por reparación protésica. Revista Hispanoamericana de Hernia, 3(1), 29–31.
VIII. Márquez-Hernández, J., Barrabí-Díaz, A., Armas-Pérez, B. A., & Guillén-Pacheco, B. (2016). Hernia lumbar bilateral de Grynfelt-Lesshaft: un nuevo reporte. Revista Archivo Médico de Camagüey, 20(4).
IX. Fonseca-Sosa, F., Romero-Castillo, Y., Córdova-González, A., Milanes-Sánchez, T., & Ondo-Ntutumu, P. (2022). Hernia lumbar de Petit: a propósito de un caso. Revista de Cirugía Gallega, 6(7).
X. González-Rodríguez, F., Paulos-Gómez, A., & López, M. (2014). Hernia de Grynfelt: discusión y manejo. Revista Hispanoamericana de Hernia.