Authors: Barry AM, Sylla H, Balde TM, Sylla A, Doumbouya B, Diallo MSK, Toure I, Camara FL, Fofana H, Toure A.
Lumbar hernia is the protrusion of a viscera or fat through a congenital or acquired breachin thelumbarregion [1]. The aim of our study was to report 5 cases of lumbar hernia treated in the department and to review the literature.
Patients and Methods: This is a descriptive retrospective study from January 1, 2017 to December 31, 2023, i.e. 7 years. Patients of both sexes operated for lumbar hernia and confirmed intraoperatively were included.
Results: During the study period, 5 cases of lumbar hernia were recorded in the visceral surgery department of Koundara Prefectural Hospital. This was out of a total of 1055 hernia cases, i.e. a frequency of 0.47%, with an average frequency of 1 case/year. The mean age of patients was 66.2 years, with extremes ranging from 42 to 84 years. They were predominantly male, with a sex ratio of 4. All cases of hernia were acquired, with a mean course of 11.6 months. According to topography, we recorded 4 cases of jean louis petit hernia, including one (1) on the left, two (02) on the right, one (01) bilateral and 1 case of left Grynfelt hernia. Ultrasonography was performed in all patients; none of the patients in this series had undergone CT scanning. The approach was lumbar. Surgical exploration revealed : Omentum + small intestine in two (02) patients, sigmoid colon and omentum in one (01) case, fatty mass + omentum in one (01) case, necrotic omentum and sac wall in one (01) case, no bowel resection was performed and epiploic resection was performed in 2 patients, Four (04) patients underwent parietal repair using a raphia, while one (01) patient underwent insertion of a non-absorbable prosthesis. Postoperative followup was straightforward in four (04) patients, with one (01) case of parietal suppuration. Length of stay was generally short, from 2 to 6 days, with an average of 2 days.
Conclusion: Lumbar hernia is rare. Weakness of the posterior abdominal wall and intra-abdominal hyperpressure are thought to be the main factors favoring this pathology. Diagnosis is clinical and difficult unless the hernia is strangulated. Imaging plays a role in diagnosis. In our resource-poor environment, the surgeon must refine the clinical detection of this condition, as most patients do not have sufficient means to perform a CT scan, which remains the gold standard.
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