CONGENITAL LUMBAR HERNIA: A CASE SERIES STUDY  

Nian Noori Ameen a and Mohammed Kamil Mohammed b


Department of Surgery, College of Medicine, University of Sulaimani. 
b Department of Surgery, AL-Mustansiriya University, Iraq


Submitted: 13/8/2017; Accepted: 24/12/2017; Published 15/4/2018
ABSTRACT


Background 

Congenital lumbar hernia is a rare anomaly with only 45 cases reported in the English-language literature, usually presents since birth either isolated or, less commonly, in association with other congenital malformations.


Objectives 


This study done to record the prevalence rate of this very rare congenital anomaly at Sulaimani province, with reviewing the important clinical and anatomical aspects, along with the current surgical management of this malformation.


Methods

A case series study on just four cases presented over period of 10 years (May 2007 to June 2017), data were collected regarding the age at presentation, sex, associated anomalies, surgical management, and outcome, with measuring the prevalence rate.


Results

During the study period only four patients were recorded to have congenital lumber hernia. Male to female ratio was 1:1. All of them presented during infancy, with unilateral, and right sided CLH. One female presented with recurrence after a previous surgical correction. Lumbocostvertiberal syndrome was an associated anomaly in a female patient; bilateral undescended testes in a male patient. Three cases were managed with open surgical repair; without post operative morbidity and mortality. The recurrent case’s father declined further surgery. 


Conclusion

CLH is a rare condition. The diagnosis is usually clinical. Due to the high frequency of associated congenital anomalies, a proper physical examination supplemented by plain X-ray and US study is important in every case. The treatment is surgical repair as soon as possible. There is a high chance of recurrence if big defect not corrected with meshplasty.


KEYWORDS

Congenital Lumbar Hernia (CLH), Grynfeltt Hernia (GH), Petit Hernia (PH), Superior Lumbar Hernia (SLH), Inferior Lumbar Hernia (ILH).