Management Criteria of Grynfeltt's Lumbar Hernia: A Case Report and Review of Literature

Grynfeltt's lumbar hernia is a rare abdominal wall pathology with around 300 cases described in the literature. Recently, a therapeutically aimed classification was proposed analysing the size, location, contents, muscular atrophy, origin, and existence of the previous recurrence. Surgical repair is the only definitive treatment option through either an open or laparoscopic approach. An 87-year-old female came to consult for swelling in the right lumbar area without traumatic history. A smooth, reducible, and tender mass of 4 x 3 cm was described. The suspicion of a Grynfeltt's hernia was confirmed by lumbar ultrasound with evidence of a 10 mm abdominal wall defect with the diameter increasing to 15 mm during a Valsalva maneuver. The patient had a primary type A lumbar hernia; therefore, open hernioplasty was performed. The patient was discharged from the hospital on the third postoperative day in optimal clinical condition. Her 12-month follow-up examination was uneventful. A lumbar hernia diagnosis can be challenging. Preoperative imaging has an important role in assessing the size, location, and hernia contents. The use of a therapeutically aimed classification could be useful for optimal patient management and improvement of surgical outcomes.