Inferior lumbar triangle hernia as a rarely reported cause of low back pain: a report of 4 cases

Received 29 July 2009; received in revised form 21 January 2010; accepted 3 February 2010.

Abstract

Objective

Lumbar triangle hernias are rarely reported causes of low back pain. We describe the symptoms, signs, and anatomical location of 2 possible defects in the posterior abdominal wall where lumbar hernias may appear. The clinical diagnosis was challenging, and advanced imaging failed to initially uncover the conditions.

Clinical Features

We report 4 patients with spontaneous inferior lumbar triangle hernias (Petit triangle hernias) initially presenting to a primary care clinic with the primary complaint of low back pain.

Intervention and Outcomes

Thorough histories and examinations led to successful outcomes. All 4 patients were operated on to correct the defect. No recurrence has occurred.

Conclusions

Anatomical knowledge and clinical acumen led to correct diagnosis of these rare lumbar hernias. This information should help both medical and chiropractic clinicians detect these conditions, and aid in appropriate management.

Key indexing terms: Hernia, Abdominal wall, Low back pain

a Contracted Chiropractic Physician, Naval Hospital Pensacola, Naval Branch Health Clinic NATTC, Pensacola, FL 32508

b Adjunct Clinical Faculty, Palmer College of Chiropractic, Davenport, IA 52803

c Adjunct Clinical Faculty, National University of Health Sciences, Lombard, IL 60148

d Primary Care Physician, Philadelphia, PA 19146

e President and CEO of Global Health Educators, Philadelphia, PA 19129

f Associate Professor, Drexel University College of Medicine, Philadelphia, PA 19146

Corresponding author. Naval Branch Health Clinic NATTC, 760 East Ave, Bldg 3911, Pensacola, FL 32508. Tel.: +1 850 492 5832.

PII: S1556-3707(10)00031-3

doi:10.1016/j.jcm.2010.02.001

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