Timing of traumatic lumbar hernia repair: is delayed repair safe? Report of two cases and review of the literature

Fewer than 100 cases of traumatic lumbar hernias are described in the English literature. The herniation has been described as a consequence of a combination of local tangential shearing forces combined with an acute increase in intra-abdominal pressure secondary to sudden deceleration sustained dur...

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Bibliographic Details
Published in:Hernia : the journal of hernias and abdominal wall surgery 2011-04, Vol.15 (2), p.205-209
Main Authors: Bathla, L., Davies, E., Fitzgibbons, R. J., Cemaj, S.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Back Injuries - diagnostic imaging
Back Injuries - etiology
Back Injuries - surgery
Case Report
Hernia - diagnostic imaging
Hernia - etiology
Herniorrhaphy
Humans
Lumbosacral Region
Male
Medicine
Medicine & Public Health
Time Factors
Tomography, X-Ray Computed
Wounds, Nonpenetrating - complications
Young Adult
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Summary:Fewer than 100 cases of traumatic lumbar hernias are described in the English literature. The herniation has been described as a consequence of a combination of local tangential shearing forces combined with an acute increase in intra-abdominal pressure secondary to sudden deceleration sustained during blunt abdominal trauma. Delayed diagnosis is not uncommon, as nearly a quarter of these are missed at initial presentation. These hernias are best managed by operative intervention; however, there is no well-defined treatment strategy regarding either the timing or the type of repair. Several approaches, including laparoscopy, have been described to repair these defects. Various techniques, including primary repair, musculoaponeurotic reconstruction, and prosthetic mesh repair, have been described. These repairs are usually complicated because of the lack of musculoaponeurotic tissue inferiorly near the iliac crest. We describe here two cases of traumatic lumbar hernia managed by initial watchful waiting and subsequent elective repair using a combined laparoscopic and open technique and one with and one without bone anchor fixation.
ISSN:1265-4906
1248-9204
DOI:10.1007/s10029-009-0625-8