Presentation
5 days of right back pain radiating to groin. Urinalysis normal.
Patient Data
Non-contrast CT abdomen demonstrates a focal defect in the right transversalis fascia, with herniation of right posterior pararenal fat within the superior lumbar triangle. The herniated fat demonstrates some internal stranding, which may suggest fat infarction.
Mild right perinephric fat stranding, possibly reactive. No renal calculi or hydronephrosis.
Case Discussion
This is an uncommon finding on CT KUB, for a common history of renal-type pain.
Lumbar hernias are rare hernias of the posterior abdominal wall, most commonly occurring in 50-70 year olds, often male. Superior lumbar hernias (Grynfeltt-Lesshaft hernia) are the more common type, occuring through the superior lumbar hernia. Larger hernias can contain intra- or retroperitoneal structures.
In this patient, urine MCS and blood tests were normal and he was managed with analgesia.