Inferior lumbar hernia

Case contributed by Dr Henry Knipe

Presentation

Bike accident right sided pain and haematoma.

Patient Data

Age: 49-year-old
Gender: Male
CT

CT Abdomen and pelvis

Right subcutaneous haematoma and fat stranding. Traumatic inferior lumbar triangle hernia on the right containing fat. The right psoas muscle and right quadratus lumbar muscle are both swollen in keeping with haematoma.

Liver, adrenal glands, gallbladder, kidneys and pancreas are normal. Spleen is unchanged and within its inferior pole is a 2.5 centimetre peripherally calcified cyst. No intraperitoneal haemorrhage. No intraperitoneal free fluid or free gas.

Undisplaced fracture through the left L2 superior articular process involving the articular surface.

Moderately displaced right L2-L4 transverse process fractures.

Right ASIS avulsion fracture. Alignment is normal. Minor degenerative change of the lumbar spine.

Case Discussion

  • inferior lumbar hernias occurs through the inferior lumbar triangle (below the 12th rib and above the iliac crest)
  • most commonly after trauma or surgery
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Case information

rID: 34496
Case created: 24th Feb 2015
Last edited: 28th Jan 2016
Tag: trauma
Inclusion in quiz mode: Included

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