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HERNIA4
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- Lumbar hernia
- Inferior triangle lumbar hernias Parastomal hernia
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Lumbar region anatomy
The lumbar region is bounded above by the 12th rib, below by the Iliac crest, posteriorly by the erector spine muscle and anteriorly by a vertical line drawn from tip of the 12th rib to Iliac crest. It contains the superior (Grynfeltt-Lesshaft’s) lumbar triangle and inferior (Pe- tit’s) lumbar triangle. The superior triangle bordered medially by the quadratus lumbo- rum muscle, laterally by the internal abdominal oblique muscle and superiorly by the 12th rib. The floor of the superior lumbar triangle is the transversalis fascia and its roof is the external abdominal oblique muscle. Petit’s triangle lies in the posterolateral abdominal wall bounded anteriorly by free margin of external oblique muscle, posteriorly by latissimus dorsi and inferiorly by iliac crest. The floor of the inferior lumbar triangle is the internal abdominal oblique muscle. * Petit’s triangle ** Grynfeltt’s triangle LD: Latissimus Dorsi muscle ES: Erector Spinae muscle Arrow: External Oblique muscle Arrowhead: Internal Oblique muscle Lumbar hernia Lumbar hernias are rare hernias involving the protrusion of intra- peritoneal or extraperitoneal contents in the lumbar region. Lumbar hernias are classified depending on whether they pass through the superior (Grynfeltt) or inferior (Petit) lumbar triangle and these two anatomical sites account for 95% of lumbar hernias (4,8) . Inferior triangle lumbar hernias Parastomal hernia Parastomal hernias are considered subtype of incisional hernias with bowel protrusion adjacent to a stoma. These rarely incarcerate but can compromise the viability of the stoma by compression. Parasto- mal hernias are attributed to many causes including; placement of the stoma outside the rectus sheath, an oversized defect created in the abdominal wall through which the stoma protrudes, increased intra-abdominal pressure, location of the stoma in a midline inci- sion, wound infection at the mucocutaneous border, poor abdomi- nal muscle tone due to aging, weight gain (6,9) . Download 6 Mb. Do'stlaringiz bilan baham: 
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