A male neonate was referred with congenital deficiencies of musculofacial layers of both lumbar spaces (Fig. 1). He also had ptosis of left eye. The diagnostic work up did not reveal any other associated skeletal, central nervous system or urological anomalies. Hernioplasty using prolene mesh was done at the age of two years, one side at a time. Post-operative course was uneventful with no recurrence noted after 6 months.

Congenital lumbar hernias are among the rarest of abdominal wall hernias. The congenital lumber hernias account for only one fifth of all lumbar hernias, the commoner causes being-post-operative and post-traumatic. Three types of congenital hernias are described: diffuse lumbar muscle deficiency (as seen in the present case), inferior lumbar defect of Petit, and superior lumbar defect of Grynfelt-Lesshoft. These hernias result from neuromuscular deficiencies of the lateral abdominal wall which causes it to degenerate and be replaced by connectiven-tissue. Repair needs to be individualized depending upon the size of the defect.


 

Fig. 1. Bilateral congenital lumbar hernias, left side bigger than  the right.