Clinicoradiological findings of a rare type of lumbar hernia
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A surgeon will rarely see a case of lumbar hernia in his lifetime. They are usually divided into superior and inferior types, but in cases of huge hernias where anatomical. delineation is not possible, they are called as diffuse.A 50-year-old male presented with complaints of a lump on his right lower back for 2 years. On examination, there was a 28 × 18 × 12-cm swelling on his right lumbar region that was soft and with a positive cough impulse. There was a 1-cm by 3-cm defect on the swelling with prolapsed omentum and a part of the ileum that reduced when the patient was made supine. A clinical diagnosis of eviscerated primary lumbar hernia was made which was confirmed by contrast CT scan.

During surgery, the defect was bounded superiorly by the 12th rib, medially by the latissimus dorsi, laterally by the external oblique muscle, and inferiorly by the iliac crest. Diagnosis of diffuse lumbar hernia was made as the superior and inferior lumbar triangles were not clear. Incision was made over the hernia site, and contents were reduced. A defect was repaired using PROLENE no.1 in continuous fashion. Onlay repair of the defect with prosthetic mesh (polypropylene, 15 × 15 cm) was done. Mesh was sutured to the external oblique, latissimus dorsi, and the lumbar periosteum...

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