Primary Superior Lumbar Hernia with Nephrotic-range Orthostatic Proteinuria

Area of Science:

• Abdominal wall anatomy
• Nephrology
• Surgical case reports

Background:

• Lumbar hernias, occurring in the superior (Grynfeltt-Lesshaft's triangle) or inferior (Petit's triangle) lumbar triangles, are exceptionally rare abdominal wall defects.
• These anatomical weak points can lead to superior and inferior lumbar hernias, respectively.

Observation:

• A 67-year-old woman presented with nephrotic-range proteinuria.
• The patient also exhibited flank swelling, a potential indicator of an underlying lumbar hernia.

Findings:

• The proteinuria was diagnosed as being caused by a primary superior lumbar hernia.
• This finding suggests a link between superior lumbar hernias and massive orthostatic proteinuria in adult patients.

Implications:

• Superior lumbar hernias should be included in the differential diagnosis for adults presenting with massive orthostatic proteinuria and flank swelling.
• Early diagnosis and management of lumbar hernias are crucial to prevent potential complications arising from a missed diagnosis.