Images in clinical medicine | Volume 37, Article 166, 15 Oct 2020 | 10.11604/pamj.2020.37.166.10702

Hernia of the Jean Louis Petit triangle in the emergency department: a rare image

Hassen Ben Ghezala, Najla Feriani

Corresponding author: Hassen Ben Ghezala, Service Universitaire des Urgences et de Réanimation Médicale, Hôpital Régional de Zaghouan, Faculté de Médecine de Tunis, Tunis, Tunisie

Received: 09 Sep 2016 - Accepted: 31 Oct 2016 - Published: 15 Oct 2020

Domain: Clinical medicine

Keywords: Lumbar hernia, lumbar triangle, surgery

©Hassen Ben Ghezala et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Hassen Ben Ghezala et al. Hernia of the Jean Louis Petit triangle in the emergency department: a rare image. Pan African Medical Journal. 2020;37:166. [doi: 10.11604/pamj.2020.37.166.10702]

Available online at: https://www.panafrican-med-journal.com/content/article/37/166/full

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Images in clinical medicine

Hernia of the Jean Louis Petit triangle in the emergency department: a rare image

Hernia of the Jean Louis Petit triangle in the emergency department: a rare image

Hassen Ben Ghezala1,&, Najla Feriani1

 

1Service Universitaire des Urgences et de Réanimation Médicale, Hôpital Régional de Zaghouan, Faculté de Médecine de Tunis, Tunis, Tunisie, 2Service Universitaire de Chirurgie Générale, Hôpital Régional de Zaghouan, Faculté de Médecine de Tunis, Tunis, Tunisie

 

 

&Corresponding author
Hassen Ben Ghezala, Service Universitaire des Urgences et de Réanimation Médicale, Hôpital Régional de Zaghouan, Faculté de Médecine de Tunis, Tunis, Tunisie

 

 

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Lumbar hernias are rare lesions. They are exceptionally observed and reported. They are in most of the cases secondary to trauma or previous surgery but primary lumbar hernias are rare. Computed tomography (CT) is a very useful tool for the diagnosis of lumbar hernia. It can delineate the neck of the hernia and hernial contents. All lumbar hernias must be treated with surgery with two possible surgical approaches: the anterior approach and the laparoscopic approach. Many techniques have been described, including primary repair, local tissue flaps and conventional mesh repair. Bowel resection may be required in cases with strangulation. We report in this work an exceptional case of a 43 year old man with a past recent medical history of lumbar trauma who attended the emergency room for a lumbar mass. It was a soft, non-tender, reducible swelling, measuring from five centimeters in diameter, sitting in the right lumbar region. Computed tomography was performed. The hernia was located in the superior triangle of Grynfelt-Lesshaft and contained large intestine of the right bowel. That is called hernia of the Jean Louis Petit triangle. The patient had open surgery (by lumbar incision). We reintroduced the intestine back into the peritoneal cavity. We excised the sac, and repaired the defect by using synthetic mesh placed below the muscular layers, using a tension-free technique. He was discharged at the fifth day from our hospital. He has been followed up four years with no recurrence or postsurgical sequelae.

 

 

Figure 1: lumbar hernia containing large bowel through superior triangle (Grynfelt)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Images in clinical medicine

Hernia of the Jean Louis Petit triangle in the emergency department: a rare image

Images in clinical medicine

Hernia of the Jean Louis Petit triangle in the emergency department: a rare image

Images in clinical medicine

Hernia of the Jean Louis Petit triangle in the emergency department: a rare image

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Key words

Lumbar hernia

Lumbar triangle

Surgery

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Hernia of the Jean Louis Petit triangle in the emergency department: a rare image