Primary acquired Grynfeltt Hernia: two new cases and literature review

Abstract

AIM: We report two cases of the very rare Primary Acquired Grynfeltt Hernia. The related abdominal wall defects were repaired, by open surgery, placing a partially absorbable plug and mesh. The observation and management of these two new cases prompted us to review the literature with the purpose of suggesting the most appropriate surgical approach and technique.

MATHERIAL OF STUDY: A 60 years old female patient showing a swelling at the left lumbar region, and a 76 years old male patient showing evidence of a tumefaction located at the right lumbar region, were diagnosed at our department with Primary Acquired Grynfeltt Hernia.

RESULTS: Postoperative courses were uneventful and the patients were discharged from hospital respectively on the third and second postoperative day. Follow-up at thirty days, six months, two and three years showed no signs of recurrence. DISCUSSION: Primary Acquired Grynfeltt Hernia is one of the rarest abdominal hernias. In literature there are no com- parative studies showing which type of surgical approach should be preferred for this specific abdominal wall defect. In our department, open surgery was successfully performed for the treatment of two new cases of Primary Acquired Grynfeltt Hernias and, second time in literature, partially absorbable plug and mesh were placed in order to repair the causative abdominal wall defect.

CONCLUSION: Based on our experience and literature review, we consider open hernia repair with partially absorbable plug and mesh as an appropriate and advisable surgical approach for not complicated cases of Primary Acquired Grynfeltt Hernia. Surgery is performed rapidly, effortlessly and securely if the patient is under general anesthesia, in lateral decu- bitus position with the operating table flexed at the level of the iliac crest.