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May 1982

Picture of the Month

Am J Dis Child. 1982;136(5):457-458. doi:10.1001/archpedi.1982.03970410075018

Denouement and Discussion 

Congenital Lumbar Hernia 

Manifestations  Congenital lumbar hernia usually appears in the newborn as a large, compressible, soft-tissue mass that may increase in size when the infant cries. It is located at the weak points of the superior (Grynfeltt-Lesshaft) and inferior (Petit's) lumbar triangles. Most congenital lumbar hernias are unilateral and involve the fascia, aponeuroses, and muscles.Varying degrees of scoliosis are frequently present, secondary to lower thoracic and lumbar hemivertebrae and shortening of the intercostal spaces. Eventration of the diaphragm and homolateral absence of the testes have also been reported. Roentgenograms show the hernia and air-filled loops of bowel within its sac, as well as the vertebral malformations and shortening of the intercostal spaces.

Etiology  The abdominal wall malformation may be primary or secondary to abnormal vertebral development. It does not appear to be an inherited disorder.

Treatment  Surgical correction is necessary but the need for