The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Grynfeltt Hernia (Superior Lumbar Triangle Hernia)

Rare lumbar hernia through the superior lumbar triangle of Grynfeltt-Lesshaft, bordered by the 12th rib, internal oblique, and quadratus lumborum, more common than the inferior lumbar (Petit) hernia and treated by open or laparoscopic mesh reinforcement.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Grynfeltt Hernia (Superior Lumbar Triangle Hernia)?

Grynfeltt hernia (also called Grynfeltt-Lesshaft hernia) is a rare lumbar hernia through the superior lumbar triangle bounded superiorly by the 12th rib and inferior border of the serratus posterior inferior, medially by the quadratus lumborum and erector spinae, and laterally by the internal oblique; the floor is formed by the transversalis fascia and aponeurosis.

Hernias may be congenital (primary) or acquired (secondary) following lumbar surgery (e.g., flank nephrectomy, iliac crest harvest), trauma, infection, or denervation; they typically contain retroperitoneal fat, kidney, colon, or small bowel and tend to enlarge over time.

Diagnosis is supported by physical examination of a reducible posterolateral mass increasing with Valsalva and confirmed by computed tomography or magnetic resonance imaging that delineates defect size, hernia contents, and surrounding muscular and fascial structures for surgical planning.

Symptoms

Reducible posterolateral flank bulge in the upper lumbar region, more prominent with coughing or standing
Dull lumbar back pain or flank discomfort, often increased with activity or prolonged standing
Pain radiating to groin or gluteal region
Acute incarceration with persistent pain, tender mass, and bowel obstruction features
Strangulation: severe pain, vomiting, fever, signs of peritonitis (rare but emergency)
Incidental finding on imaging performed for other indications

Risk Factors

Older age, with progressive weakening of the abdominal wall
Previous lumbar surgery, especially nephrectomy, adrenalectomy, or iliac crest bone graft harvest
Lumbar or flank trauma producing muscular or fascial disruption
Chronic raised intra-abdominal pressure: chronic cough, constipation, obesity, ascites
Connective tissue disorders, malnutrition, corticosteroid therapy
Heavy manual labor with sustained mechanical strain on lumbar musculature

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • New upper flank mass with discomfort, particularly after flank surgery or trauma — surgical evaluation with imaging
  • Known Grynfeltt hernia with progressive symptoms or enlargement — outpatient surgical reassessment
  • Acute irreducible flank mass with severe pain or vomiting — emergency assessment for incarceration or strangulation
  • Recurrent hernia after previous repair — referral to specialized hernia surgeon
  • Patient considering elective surgery — preoperative anesthesia, optimization of comorbidities, and surgical risk assessment

Treatment Methods

01
Elective mesh repair is recommended for symptomatic hernias and considered for asymptomatic patients to prevent incarceration; observation may be selected in high-risk individuals
02
Open posterolateral approach with retromuscular sublay or onlay mesh placement using prosthetic (lightweight polypropylene) or biologic mesh depending on defect size and surgical risk
03
Laparoscopic transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) approach with intraperitoneal or retroperitoneal mesh, beneficial in patients with previous abdominal surgery
04
Robotic-assisted lumbar mesh repair for complex anatomy, recurrence, or large defects in selected centers
05
Postoperative care: adequate analgesia, early mobilization, control of cough and constipation, weight management, and follow-up for wound healing and long-term recurrence surveillance

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Genel Cerrahi Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Appendicitis

Genel Cerrahi

Appendicitis is inflammation of the appendix causing severe pain in the lower right abdomen. Early diagnosis and surgical treatment are life-saving.

Inguinal Hernia

Genel Cerrahi

Inguinal hernia is the protrusion of intestine or fat into the inguinal canal due to weakness in the abdominal wall. It can be permanently corrected with surgical treatment.

Umbilical Hernia

Genel Cerrahi

Umbilical hernia manifests as a soft swelling around the navel. While it often resolves spontaneously in infants, surgical treatment may be required in adults.

Gallstones and Cholecystectomy

Genel Cerrahi

Gallstones cause severe pain in the upper right abdomen, especially after fatty meals. They are safely treated with laparoscopic cholecystectomy.

Hemorrhoids (Piles)

Genel Cerrahi

Hemorrhoids result from swelling of the veins in the anus; they present with blood on toilet paper, itching, and pain. Various treatments are available, from lifestyle changes to surgery.

Anal Fissure

Genel Cerrahi

Anal fissure is a tear in the thin skin of the anal canal. It presents with sharp pain and bleeding and can be healed with medical or surgical treatment.

Pilonidal Sinus

Genel Cerrahi

Pilonidal sinus consists of tunnels and tracts prone to chronic infection, formed by hair becoming embedded under the skin in the tailbone area. Surgical treatment provides a permanent solution.

Thyroid Surgery

Genel Cerrahi

Thyroid surgery involves the removal of part or all of the thyroid gland for indications such as benign nodules, goiter, and thyroid cancer.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.