特発性上腰ヘルニアの1例 本邦58例の検討

Abstract

The superior lumbar triangle is an anatomically weak space in the lumbar area. A superior lumbar hernia rarely occurs in this triangle. In this paper, a case of idiopathic superior lumbar hernia is reported with some reviews of previous literature. A 78-year-old man visited us because of a mass and pain in the right lumbar area. Physical examination revealed a 9x9cm, soft and smooth-surfaced mass. Computed tomography (CT) showed a defect in the right dorsal abdominal wall and a prolapse of the retroperitoneal fat tissue through the defect. Diagnosis of an idiopathic right superior lumbar hernia was established, and hernioplasty was performed At operation, a hernial orifice measuring 2cm in diameter was found in the aponeurosis of the transversus abdominis, and fat tissue prolapsed through this orifice. The aponeurosis was closed by several interrupted sutures and an onlay patch (Bard Mesh®) was fixed on the superior lumbar triangle.