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Case Reports
. 2016 Apr 8:7:104-6.
doi: 10.1016/j.amsu.2016.04.002. eCollection 2016 May.

Grynfelt-Lesshaft hernia a case report and review of the literature

C F Ploneda-Valencia  1 , E Cordero-Estrada  1 , L G Castañeda-González  1 , V H Sainz-Escarrega  1 , O Varela-Muñoz  1 , L F De la Cerda-Trujillo  2 , C A Bautista-López  1 , C R López-Lizarraga  3
Affiliations
Case Reports

Grynfelt-Lesshaft hernia a case report and review of the literature

C F Ploneda-Valencia et al. Ann Med Surg (Lond). .

Abstract

Introduction: Lumbar hernia account for less than 2% of al abdominal hernias, been the Grynfelt-Lesshaft's hernia (GLH) more frequent than the others. With approximately 300 cases published in the literature, the general surgeon may have the chance of treat it ones in their professional life.

Case report: A 42-years old male with human immunodeficiency virus and Diabetes Mellitus presented to the outpatient clinic with a GLH. Preoperative classified as a type "A" lumbar hernia an open approach was scheduled. We performed a Sandwich technique with a sublay and onlay ULTRAPRO(®) mesh fixed with PDS(®) II suture without complications and discharged the patient 24-h after. After six months, the patient denied any complication.

Discussion: Primary (spontaneous) lumbar hernias represent 50-60% of all GLH. The preoperative classification of a lumbar hernia is mandatory to propose the best surgical approach. According to the classification of Moreno-Egea A et al., the best technique for our patient was an open approach. The Sandwich technique has demonstrated good outcomes in the management of the GLH.

Conclusion: The surgical approach should be according to the classification proposed and to the experience of the surgeon. The Sandwich technique has good outcomes.

Keywords: Grynfelt hernia; Grynfelt-Lesshaft hernia; Lumbar hernia; Sandwich technique.

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Figures

Fig. 1
Fig. 1
CT scan shows protruding mass beneath the 12th rib. * shows the hernia content perisplenic fat.
Fig. 2
Fig. 2
Images are showing the hernia sac and wall defect after releasing the hernia sac.
Fig. 3
Fig. 3
The left image shows the sublay preperitoneal mesh and the right image shows the onlay mesh in the Sandwich technique.
See this image and copyright information in PMC

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