Ｋｕｇｅｌ　ｐａｔｃｈにて修復を行った左上腰ヘルニアの１例

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  • A CASE OF SUPERIOR LUMBAR HERNIA REPAIRED USING A KUGEL PATCH

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A hernia rarely occurs in the lumber triangle. We report a case of superior lumber hernia repaired using a Kugel patch.<br> An 86-year-old man admitted to the hospital because of a mass at the left lumbar area had an elasticsoft, non-tender, and smooth-surfaced mass 4cm in diameter in the left flank on physical examination. Computed tomography offered a diagnosis of superior lumbar hernia. At operation a 2.5×3cm welldefined defect in the transversalis fascia, which forms the floor of the superior lumbar triangle, was found, and fat tissue surrounding the kidney as well as the large intestine prolapsed from this defect. Operative repair was done by inserting a Kugel patch into the fascial defect. The postoperative course was uneventful and he was discharged from the hospital on the postoperative day 2. There have been no signs of recurrence, as of 3 months after the operation.<br> Thirty-five cases of superior lumbar hernia including ours have been reported in the Japanese literature so far. The disease is primarily treated by surgical repair, and this is the first report on repair with the Kugel patch method with tension-free herniorrhaphy in Japan. The method is considered useful because it contributes to short hospital stay.

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