Post-traumatic unilateral lumbar hernia in a 35-year-old male with delayed presentation: A retrospective case study.

Manas Ranjan  Behera; Tirupati Kumar  Jena; Chinmayee  Apata

doi:10.51168/sjhrafrica.v6i6.1735

Authors

Manas Ranjan Behera Associate Professor, Department of General Surgery, MKCG Medical College, Berhampur, Odisha, India
Tirupati Kumar Jena Postgraduate, Department of General Surgery, MKCG Medical College, Berhampur, Odisha, India
Chinmayee Apata Senior Resident, Department of Radiodiagnosis, MKCG Medical College, Berhampur, Odisha, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i6.1735

Keywords:

Lumbar hernia, post-traumatic hernia, Mesh repair, Delayed presentation, Superior lumbar triangle

Abstract

Background

A bowel or abdominal organ protruding due to a disruption of muscle and fascia after a severe physical trauma is known as a traumatic abdominal wall hernia (TAWH). Motor vehicle collisions (MVCs) are the most frequent cause of this uncommon occurrence, followed by handlebar injuries, motorcycle accidents, and falls.

Objectives

In this case, a post-traumatic lumbar hernia that was discovered three years after the accident was effectively treated with open mesh surgery.

Materials and Methods

A male construction worker, age 35, complained of a gradual, painless enlargement in his left side. Three years ago, he remembered falling from a height and suffering soft tissue contusions, but at the time, no imaging was done. Initially observed six months earlier, the bulge gradually grew and was reduced upon evaluation. A muscle deficiency with fat herniation was detected by the first ultrasonography.

Results

In the CT scan, an enhanced contrast was performed, and the abdomen and pelvis were examined. It revealed a 6 x 5 cm defect in the left inferior lumbar triangle, i.e., Grynfeltt Lesshaft triangle. Retroperitoneal fat and a small portion of the descending colon were seen herniating through this defect. There was no evidence of bowel obstruction or strangulation.

Conclusion

The significance of long-term monitoring for patients with abdominal trauma is shown by this instance. Clinicians should be aware of the potential for delayed herniation even if there are no early symptoms. Excellent long-term results can result from early diagnosis with CT and surgical intervention with mesh reinforcement.

Recommendation

This case report recommends early imaging and surgical intervention for suspected lumbar hernias to prevent complications.

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