Lumbar Hernia: An Unusual Presentation of Bear Maul

Mubashir Ahmad Shah, Aakib Hamid Charag, Adil Pervaiz Shah, Haroon Rashid Zargar

Department of General & Minimal Access Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India.
Department ofPlastic & Reconstructive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India.

DOI: 10.4236/ijcm.2013.410080                

Abstract

Introduction: Typical lumbar hernias are very rare surgical conditions. Lumbar hernias can be congenital or acquired. About 25% of all lumbar hernias have a traumatic etiology. Case-Report: We here reported a case of a 55-year-old male who was mauled by a bear. The patient developed an atypical lumbar hernia after 6 months of sustaining craniofacial and abdominal trauma. Open hernioplasty, which was a very challenging job, was done in this patient. Conclusion: Post traumatic lumbar hernias have been reported but till today no case of lumbar hernia following an attack by a bear has been reported in literature. Both acute and long-standing post-traumatic lumbar hernias are rare but challenging conditions. The corrective surgical procedure becomes more complex as hernial defect enlarges. Reconstruction is a challenging aspect of lumbar hernia surgery.

Keywords

Lumbar; Hernia; Trauma; Bear Maul

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	W. T. Swartz, “Lumbar Hernia,” In: L. M. Nyhus and R. E. Condon, Eds., Hernia, 2nd Edition, Lippincott, Philadelphia, 1978, pp. 409-426.
[2]	J. E Skandilakis and J. B. Flament, “The Surgical Clinics of North America,” Vol. 80, 2000, pp. 388-391.
[3]	W. P. Geis and G. T. Hodakowski, “Lumbar Hernia,” In: L. Nyhus and R. Condon, Eds., Hernia, 5th Edition, Lippincott, Philadelphia, 2001, pp. 425-427.
[4]	B. Devlin and A. N. Kingsnorth, “Management of Abdominal Hernias,” 2nd Edition, Edward Arnold, London, 1998, pp. 330-334.
[5]	M. E. Baker, J. L. Weinerth, R. T. Andriani, et al., “Lumbar Hernia: Diagnosis by CT,” American Journal of Roentgenology, Vol. 148, No. 3, 1987, pp. 565-567. http://dx.doi.org/10.2214/ajr.148.3.565
[6]	K. L. Killeen, S. Girard, J. H. Demeo, et al., “Use of CT to Diagnose Traumatic Lumbar Hernia,” American Journal of Roentgenology, Vol. 174, No. 5, 2000, pp. 1413-1415. http://dx.doi.org/10.2214/ajr.174.5.1741413
[7]	G. E. Leber, J. L. Garb, A. l. Albert and W. P. Reed, “Long-Term Complications Associated with Prosthetic Repair of Incisional Hernias,” Archives of Surgery, Vol. 132, 1998, pp. 1141-1144.
[8]	A. K. Meinke, “Totally Extraperitoneal Laparoendoscopic Repair of Lumbar Hernia,” Surgical Endoscopy and Other Interventional Techniques, Vol. 17, No. 5, 2003, pp. 734-737. http://dx.doi.org/10.1007/s00464-002-8557-8
[9]	B. T. Heniford, D. A. Iannitti and M. Gagner, “Laparo-scopic Inferior and Superior Lumbar Hernia Repair,” Ar-chives of Surgery, Vol. 132, No. 10, 1997, pp. 1141-1144. http://dx.doi.org/10.1001/archsurg.1997.01430340095017
[10]	P. K. Chowbey, A. Sharma, R. Khullar, et al., “Laparo-scopic Ventral Hernia Repair,” Journal of Laparoendo-scopic & Advanced Surgical Techniques, Vol. 10, No. 2, 2000, pp. 79-84. http://dx.doi.org/10.1089/lap.2000.10.79
[11]	N. Agarwal, S. Kumar, M. K. Joshi and M. S. Sharma, “Traumatic Abdominal Wall Hernia in Two Adults: A Case Series,” Journal of Medical Case Reports, Vol. 3, 2009, p. 7324. http://dx.doi.org/10.4076/1752-1947-3-7324
[12]	A. I. Sarela, A. A. Mavanur, A. Bhaskar, Z. F. Soonawala, G. Devnani, H. K. Shah, et al., “Post Traumatic Lumbar Hernia,” Journal of Postgraduate Medicine, Vol. 42, No. 3, 1996, pp. 78-80.
[13]	A. J. Burick and S. A. Parascandola, “Laparoscopic Re-pair of a Traumatic Lumbar Hernia: A Case Report,” Jour-nal of Laparoendoscopic Surgery, Vol. 6, No. 4, 1996, pp. 259-262. http://dx.doi.org/10.1089/lps.1996.6.259
[14]	A. Moreno-Egea, A. C. Alcaraz and M. C. Cuervo, “Sur-gical Options in Lumbar Hernia: Laparoscopic versus Open Repair; A Long-Term Prospective Study,” Surgical Innovation, Vol. 20, No. 4, 2013, pp. 331-344. http://dx.doi.org/10.1177/1553350612458726
[15]	D. J. Links and C. R. Berney, “Traumatic Lumbar Hernia Repair: A Laparoscopic Technique for Mesh Fixation with an Iliac Crest Suture Anchor,” Hernia, Vol. 15, No. 6, 2011, pp. 691-693. http://dx.doi.org/10.1007/s10029-010-0716-6