Hernia

Grynfeltt-Lesshaft Hernia

Lauren Ng, MD, MPH
Adam Possner, MD
Volume 52 - Issue 12 - December 2012

herniaA 52-year-old man presented to general internal medicine clinic with a 3-day history of stabbing left flank pain. He denied any fever, chills, dysuria, hematuria, nausea, vomiting, diarrhea, or constipation. Physical examination was significant for left flank tenderness.

Results of laboratory tests, including a complete blood cell count, urinalysis, and a basic metabolic panel, were all normal. An abdominal computed tomography scan was then obtained, which revealed a 2.9-cm left lumbar hernia (arrow) through the superior triangle, known as a Grynfeltt-Lesshaft hernia.

Lumbar hernias represent only about 2% of abdominal hernias. Predisposing factors include trauma, older age, obesity, extreme thinness or intense slimming, muscular atrophy, chronic bronchitis, and wound infection. The patient lacked these risk factors, but he did have a history of 2 bilateral inguinal hernia repairs, the most recent being 3 years ago. Treatment of a Grynfeltt-Lesshaft hernia is always surgical.

FOR MORE INFORMATION:
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 Morengo-Egea A, Gaena EG, Calle MC, et al. Controversies in the current management of lumbar hernias. Arch Surg. 2007;142:82-88.
 Orcutt TW. Hernia of the superior lumbar triangle. Ann Surg. 1971;173:294-297.
 Solaini L, di Francesco F, Gourgiotis S, et al. A very simple technique to repair Grynfeltt-Lesshaft hernia. Hernia. 2010;14:439-441.