Grynfeltt-Lesshaft Hernia

A 52-year-old man presented to general internal medicine clinic with a 3-day history of stabbing left flank pain. He denied any fever, chills, dysuria, hematuria, nausea, vomiting, diarrhea, or constipation. Physical examination was significant for left flank tenderness.

Results of laboratory tests, including a complete blood cell count, urinalysis, and a basic metabolic panel, were all normal. An abdominal computed tomography scan was then obtained, which revealed a 2.9-cm left lumbar hernia (arrow) through the superior triangle, known as a Grynfeltt-Lesshaft hernia.

Lumbar hernias represent only about 2% of abdominal hernias. Predisposing factors include trauma, older age, obesity, extreme thinness or intense slimming, muscular atrophy, chronic bronchitis, and wound infection. The patient lacked these risk factors, but he did have a history of 2 bilateral inguinal hernia repairs, the most recent being 3 years ago. Treatment of a Grynfeltt-Lesshaft hernia is always surgical.

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