Acute Repair of Traumatic Lumbar Hernia with Fascia Lata Autograft

A Case Report

Abstract

Traumatic lumbar hernia is a rare condition, and there is no consensus regarding its treatment. Although direct closure or mesh reconstruction is preferred for the treatment of traumatic abdominal wall hernias, we successfully repaired a traumatic lumbar hernia using a fascia lata autograft in an acute setting. A 55-year-old man experienced traumatic inferior lumbar hernia after being caught in heavy machinery. Emergency laparotomy was performed to rule out intra-abdominal organ injury and simultaneous repair of the lumbar hernia was planned. Owing to the high degree of tissue contusion around the hernia, hernia repair was performed using a fascia lata autograft rather than an artificial mesh, given the concerns surrounding secondary adverse events. The patient did not experience any major postoperative complications or recurrence. This is the first report to discuss the use of a fascia lata autograft as a repair material in a patient with acute traumatic lumbar hernia.

Intraoperative photographs.

(a) A trial laparotomy was performed through a midline abdominal incision, and several serosal injuries were repaired. No obvious intestinal injury was observed. (b) An incision was added directly above the hernia. (c) The hernial portal was identified. The size of the hernia portal was 5 × 4 cm, and a contusion of the surrounding musculature was observed. (d) A 7 × 8 cm fascia lata autograft was harvested from the opposite thigh. (e) The hernia portal was repaired using a fascia lata autograft. (f) Images were taken immediately after wound closure. In comparison to the extent shown in the photo (b) taken at the beginning of the surgery, the tissue damage around the hernia portal was more advanced.