Primary lumbar hernia: Laparoscopic correction of Grynfeltt’s hernia (GRYNFELTT)—A case report

Abstract Lumbar hernias, defined as the protrusion of intra- or extra-peritoneal contents through a defect in the posterolateral abdominal wall between the 12 th rib and the iliac crest, are extremely rare. Until 2015, only about 300 cases had been reported since the first formal publication on the subject by the French surgeon R.J.C. de Garangeot in 1731. Lumbar hernias can be classified anatomically and etiologically. Anatomically, they can be divided into superior and inferior hernias, appearing in the upper or lower lumbar triangle, respectively, and diffuse hernias, which are considerably larger and not defined by specific anatomical structures. Etiologically, they are classified as primary or secondary. Primary lumbar hernias form spontaneously, while secondary lumbar hernias result from an event such as surgical procedures or trauma. Both types of lumbar hernia are rare, but the primary hernia is the least common. Thus, when a physician encounters a patient with this complaint, it is important to report the case in order to include the incidence in available literature on this rare defect and gradually achieve a comprehensive understanding of lumbar hernias, including their risk factors, clinical presentation, diagnosis, and treatment. In this study, we present the case of a 56-year-old female patient who attended the Conde de Lara outpatient clinic at the Santa Casa de Misericórdia Hospital in São Paulo, Brazil, with the complaint of a bulge in the left lumbar region, associated with pain and constipation, which she had been experiencing for at least 3 years. The patient had a clinical history, and imaging studies had indicated diagnosis of primary lumbar hernia. She underwent laparoscopic surgery for hernia repair, with satisfactory recovery. It is worth noting that there is no consensus regarding the best surgical technique for the treatment of lumbar hernias, and the treatment performed in this case was successful. The patient’s clinical history, the diagnostic process, and the treatment will be thoroughly described in this article.