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Congenital lumbar hernia in a child
Insights
Pediatric lumbar hernia is rare and congenital. This case report details the successful surgical repair of a lumbar hernia in a 22-month-old boy, highlighting the importance of ruling out associated malformations.
Area of Science:
- Pediatric Surgery
- Abdominal Wall Reconstruction
Background:
- Pediatric lumbar hernia is an exceptionally rare diagnosis.
- Requires specialized diagnostic and therapeutic strategies.
- This report details the first pediatric lumbar hernia case in the Czech Republic.
Purpose of the Study:
- To report the first case of pediatric lumbar hernia in the Czech Republic.
- To describe the diagnostic and surgical management of a congenital lumbar hernia in a child.
Main Methods:
- A 22-month-old boy presented with a congenital lumbar mass.
- Ultrasound revealed a 17x11 mm defect in the superior lumbar triangle with bowel herniation.
- Open hernioplasty with primary closure was performed due to the small defect size.
Main Results:
- The patient underwent successful open hernioplasty with primary closure.
- The postoperative period was uneventful.
- No hernia recurrence or growth asymmetry was observed during follow-up.
Conclusions:
- Pediatric lumbar hernias are congenital and may be associated with other malformations.
- Thorough pre-operative assessment is crucial to rule out associated anomalies.
- Surgical repair aims for tension-free closure, with technique tailored to defect size.
Introduction:
Lumbar hernia in the pediatric population is an extremely rare diagnosis and therefore requires specific diagnostic and therapeutic approaches. This case report describes the first published case of a pediatric lumbar hernia in the Czech Republic.
Case Description:
A 22-month-old boy was examined at a pediatric surgical clinic due to a soft reducible mass in the right lumbar region, which, according to his mother, has been present from birth. An ultrasound scan confirmed a defect in the anatomical localization of the superior lumbar triangle (the triangle of Grynfeltt-Lesshaft) measur-ing 17 × 11 mm with a bowel loop herniation. The patient underwent a skeletal X-ray and an abdominal ultrasound in order to rule out associated malformations, following which he was scheduled for an open hernioplasty. Given the small size of the defect, a primary closure without mesh hernioplasty was performed. The postoperative course was uneventful and at clinical follow-ups the patient showed no signs of hernia recurrence or growth asymmetry.
Conclusion:
Lumbar hernia in children is congenital and frequently occurs with other associated malformations, which must be ruled out. The type of operation depends on the size of the defect and its purpose is to provide a tension-free closure.
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