Traumatic lumbar hernia: A systematic review of the literature
Purpose: Traumatic lumbar hernia (TLH) constitutes a protrusion of content through a defect in the posterior abdominal wall, as a result of injury. This rare entity has been described in limited number of cases. Methods: A systematic review of the literature was performed according to the meta-analy...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-01-01
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| Series: | Chinese Journal of Traumatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1008127523000482 |
| _version_ | 1797328838551666688 |
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| author | Ioannis Tsouknidas Nikolaos Tasis Maria Ioanna Antonopoulou Vasileios Acheimastos Dimitrios K. Manatakis |
| author_facet | Ioannis Tsouknidas Nikolaos Tasis Maria Ioanna Antonopoulou Vasileios Acheimastos Dimitrios K. Manatakis |
| author_sort | Ioannis Tsouknidas |
| collection | DOAJ |
| description | Purpose: Traumatic lumbar hernia (TLH) constitutes a protrusion of content through a defect in the posterior abdominal wall, as a result of injury. This rare entity has been described in limited number of cases. Methods: A systematic review of the literature was performed according to the meta-analysis of observational studies in epidemiology guidelines. The English literature from 1990 until 2021 was reviewed, using PubMed, EMBASE and Google Scholar bibliographic databases, to identify case reports and case series with patients that were diagnosed with TLH. For each eligible study, demographics, clinical presentation, hernia characteristics, preoperative imaging investigations, operation details, and postoperative data were extracted for assessment. Statistical analysis was performed on SPSS, version 20.0. Results: A total of 62 studies were included for review, with 164 patients with TLH. Mean age was (42.6 ± 14.3) years (47.6% males, 31.1% females, gender not specified in 35 cases). Mean diameter of hernia neck was (6.3 ± 3.1) cm, while the triangles of Petit and Grynfeltt were affected in 74.5% and 14.6%, respectively. Patients diagnosed in the emergency setting account for 54.2%, with CT scan establishing diagnosis in all but one case (97.7%). A delayed diagnosis was made in 45.8%, at a mean 1 year following trauma. Flank bulging (82.8%) and chronic back pain (34.3%) were the most frequent symptoms. In both delayed and acute group, open surgery (63.6% and 92.3%, respectively) was the preferred surgical approach. Postoperative complications were reported in 11.4% of acute and 15.0% of delayed patients. Hernia recurrence was 7%. Conclusions: TLH is uncommon with 164 cases described since 1990. CT scan is the gold standard in diagnosis. Open surgery is generally the preferred approach, particularly in the emergency setting. Acute TLH can be treated either by primary suture repair or mesh, depending on the local conditions, whereas delayed cases usually require a mesh. |
| first_indexed | 2024-03-08T06:56:43Z |
| format | Article |
| id | doaj.art-39687492de9a41db9573ac28d4dc33ab |
| institution | Directory Open Access Journal |
| issn | 1008-1275 |
| language | English |
| last_indexed | 2024-03-08T06:56:43Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Chinese Journal of Traumatology |
| spelling | doaj.art-39687492de9a41db9573ac28d4dc33ab2024-02-03T06:34:40ZengElsevierChinese Journal of Traumatology1008-12752024-01-012715357Traumatic lumbar hernia: A systematic review of the literatureIoannis Tsouknidas0Nikolaos Tasis1Maria Ioanna Antonopoulou2Vasileios Acheimastos3Dimitrios K. Manatakis4Department of Surgery, Stony Brook University Hospital, Stony Brook, New York, USA; Corresponding author.Department of Surgical Oncology, St Savvas Cancer Hospital, Athens, Greece; 2nd Department of Surgery, Athens Naval and Veterans Hospital, Athens, GreeceDepartment of Surgery, Naval Hospital of Crete, Chania, Greece2nd Department of Surgery, Athens Naval and Veterans Hospital, Athens, Greece2nd Department of Surgery, Athens Naval and Veterans Hospital, Athens, GreecePurpose: Traumatic lumbar hernia (TLH) constitutes a protrusion of content through a defect in the posterior abdominal wall, as a result of injury. This rare entity has been described in limited number of cases. Methods: A systematic review of the literature was performed according to the meta-analysis of observational studies in epidemiology guidelines. The English literature from 1990 until 2021 was reviewed, using PubMed, EMBASE and Google Scholar bibliographic databases, to identify case reports and case series with patients that were diagnosed with TLH. For each eligible study, demographics, clinical presentation, hernia characteristics, preoperative imaging investigations, operation details, and postoperative data were extracted for assessment. Statistical analysis was performed on SPSS, version 20.0. Results: A total of 62 studies were included for review, with 164 patients with TLH. Mean age was (42.6 ± 14.3) years (47.6% males, 31.1% females, gender not specified in 35 cases). Mean diameter of hernia neck was (6.3 ± 3.1) cm, while the triangles of Petit and Grynfeltt were affected in 74.5% and 14.6%, respectively. Patients diagnosed in the emergency setting account for 54.2%, with CT scan establishing diagnosis in all but one case (97.7%). A delayed diagnosis was made in 45.8%, at a mean 1 year following trauma. Flank bulging (82.8%) and chronic back pain (34.3%) were the most frequent symptoms. In both delayed and acute group, open surgery (63.6% and 92.3%, respectively) was the preferred surgical approach. Postoperative complications were reported in 11.4% of acute and 15.0% of delayed patients. Hernia recurrence was 7%. Conclusions: TLH is uncommon with 164 cases described since 1990. CT scan is the gold standard in diagnosis. Open surgery is generally the preferred approach, particularly in the emergency setting. Acute TLH can be treated either by primary suture repair or mesh, depending on the local conditions, whereas delayed cases usually require a mesh.http://www.sciencedirect.com/science/article/pii/S1008127523000482Lumbar herniaPetitGrynfelttTraumatic lumbar herniaTrauma |
| spellingShingle | Ioannis Tsouknidas Nikolaos Tasis Maria Ioanna Antonopoulou Vasileios Acheimastos Dimitrios K. Manatakis Traumatic lumbar hernia: A systematic review of the literature Chinese Journal of Traumatology Lumbar hernia Petit Grynfeltt Traumatic lumbar hernia Trauma |
| title | Traumatic lumbar hernia: A systematic review of the literature |
| title_full | Traumatic lumbar hernia: A systematic review of the literature |
| title_fullStr | Traumatic lumbar hernia: A systematic review of the literature |
| title_full_unstemmed | Traumatic lumbar hernia: A systematic review of the literature |
| title_short | Traumatic lumbar hernia: A systematic review of the literature |
| title_sort | traumatic lumbar hernia a systematic review of the literature |
| topic | Lumbar hernia Petit Grynfeltt Traumatic lumbar hernia Trauma |
| url | http://www.sciencedirect.com/science/article/pii/S1008127523000482 |
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