Abdomen Radiology / Emergency Radiology
Traumatic Right Inferior Lumbar Hernia
- Blunt abdominal trauma presented with right flank pain
- Disruption of the right lateral abdominal wall muscles, just cranial to the right iliac crest, where intra-abdominal fat is seen herniating through the relatively large defect along with ileal bowel loops. Overlying abdominal wall subcutaneous fat hemorrhage supports the traumatic etiology of the hernia (along with the patient’s clinical history).
- Traumatic abdominal wall hernias are rare and they can be easily missed clinically because abdominal wall tenderness and ecchymosis may be the only findings.
- That’s why imaging play crucial role in making such diagnosis.
- If the radiologist doesn’t have a systematic approach, he/she might miss the diagnosis also.
- Comparison of right and left abdominal wall muscles is the corner stone of diagnosis.
- From my experience, the emergency radiologist focus is usually on the abdominal viscera because they are frequently injured post blunt abdominal trauma and abdominal wall pathology could be missed
- The inferior lumbar triangle (also known as Petit triangle) is an anatomical space through which inferior lumbar hernias can occur. It is bounded by iliac crest inferiorly, external oblique muscle anteriorly and latissimus dorsi muscle posteriorly.
