Management of Lumbar Hernia Secondary to Retroperitoneal Abscess Drainage

Lumbar hernia is a rare defect that develops through the posterolateral abdominal wall. It can be classified as either congenital or acquired and may occur secondary to traumatic, iatrogenic, or infectious etiologies. Surgical management is the standard approach, with laparoscopic techniques emerging as the preferred method.A 47-year-old woman presented with swelling and pain in the left flank several months after undergoing a left laparoscopic adrenalectomy, which resulted in an abscess formation requiring interventional radiologic (IR) drainage. A computed tomography (CT) scan confirmed a left lumbar hernia, and an open mesh repair was performed. Due to their rare presentation, lumbar hernias do not have a standardized treatment algorithm. Both open and laparoscopic approaches can be utilized, but mesh repair is usually required to prevent hernia recurrence. Considering the surrounding musculature and bony prominences, knowledge of the anatomy is key to a successful and durable repair. Lumbar hernias should be considered a potential complication arising from drain placement in the flank. Surgical repair is appropriate for symptomatic lumbar hernias. The choice between laparoscopic and open approaches is made based on various patient-related considerations.