Congenital superior lumbar hernia in a six-month-old girl: a case report

Abstract

Background: Congenital lumbar hernia is a rare defect of the posterior abdominal wall in children. It can occur on its own or with vertebral, rib, renal, or other abdominal-wall anomalies. So, careful clinical evaluation and appropriate imaging are needed [1, 2].

Case presentation: A six-month-old girl from Dinajpur, Bangladesh presented with a reducible swelling over the lumbar region that had been present since birth. The swelling had stayed the same size and was not associated with pain, vomiting, bowel disturbance, or any other symptom. On examination it was localized to the superior lumbar triangle (the Grynfeltt–Lesshaft triangle). An ultrasound performed during follow-up at around five months suggested that the herniated content might be the kidney. At surgery under general anaesthesia, however, only bowel was found within the sac; no kidney was present. No other congenital anomaly was detected. The defect was repaired using vicryl sutures, and the child was doing well at the one-week postoperative visit.

Conclusion: As congenital lumbar hernia is rarely reported, accurate diagnosis and regular follow-up remain important. Careful assessment of sac contents during surgery, along with screening for associated anomalies, is essential [1, 2]. Early repair has been described in paediatric series, but longer follow-up is still needed before recurrence can be judged [3].

Journal of Paediatric Surgeons of Bangladesh (2026) Vol. 17 (2): 100-102