PMC3789277_01
Left-sided congenital lumbar hernia.
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fig1
As per the mother's description the swelling was present since birth and had increased in size over a period of time (Figure 1).
X-ray of the chest region and abdomen showing absence of lower ribs on the left side and scoliosis.
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fig2
Chest X-ray revealed the absence of the lower ribs on the left side with scoliosis of the spine (Figure 2).
CT scan showing severely hypoplastic posterior abdominal muscles (erector spinae, iliocostalis, and latissimus dorsi) causing posterolateral herniation of the spleen. D10-12 vertebral bodies are hemivertebrae.
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fig3
They were absence of the lower two ribs on the left side, attenuation of the left posterolateral body wall musculature (erector spinae, iliocostalis, and latissimus dorsi), a musculoaponeurotic defect with herniation of the spleen, hemivertebrae, and scoliosis (Figure 3).
The defect in the hypoplastic musculature.
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fig4
The defect was identified amidst hypoplastic surrounding musculature (Figure 4).
Defect in the attenuated musculature with the sac dissected up to the neck.
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fig5
The sac was identified and dissected all around up to the neck (Figure 5).
A prosthetic mesh placed between the inverted sac and the muscular layer.
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fig6
A semiabsorbable prosthetic mesh was placed over the defect with overlapping flap closure of the adjacent musculature (Figures 6 and 7).
The defect closed over the mesh with overlapping flaps of the adjacent musculature.
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fig7
A semiabsorbable prosthetic mesh was placed over the defect with overlapping flap closure of the adjacent musculature (Figures 6 and 7).