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Petit Hernia (Inferior Lumbar Triangle Hernia)

Rare lumbar hernia through the inferior lumbar triangle of Petit, bordered by latissimus dorsi, external oblique, and iliac crest, presenting as a posterior flank bulge with risk of incarceration; treated by open or laparoscopic mesh repair.

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.

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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 Petit Hernia (Inferior Lumbar Triangle Hernia)?

Petit hernia is a rare posterolateral abdominal wall hernia that protrudes through the inferior lumbar triangle of Petit, anatomically bounded by the iliac crest inferiorly, the lateral edge of the latissimus dorsi posteriorly, and the posterior edge of the external oblique muscle anteriorly, with the floor formed by the internal oblique muscle.

Hernias may be primary (congenital weakness of the abdominal wall) or secondary (after trauma, lumbar surgery, infection, or muscle denervation), and they tend to enlarge over time, increasing the risk of pain, incarceration, or strangulation of bowel, retroperitoneal fat, or kidney.

Diagnosis combines bedside examination of a reducible flank bulge that increases with Valsalva, and confirmatory cross-sectional imaging with computed tomography or magnetic resonance imaging defining the defect size, contents, and surrounding anatomy for surgical planning.

Symptoms

Soft, reducible posterolateral flank bulge that enlarges with standing, coughing, or straining
Dull aching or burning pain in the lower back or flank, especially with prolonged standing or activity
Discomfort radiating to groin, gluteal area, or upper thigh
Symptoms of incarceration: persistent painful, tender, irreducible mass with bowel obstruction features
Strangulation symptoms: severe pain, fever, vomiting, peritonitis (uncommon but serious)
Asymptomatic incidental finding on abdominal imaging performed for other reasons

Risk Factors

Older age and progressive abdominal wall weakness
Previous lumbar surgery (e.g., flank incision for nephrectomy, iliac crest bone graft harvest, lumbar discectomy)
Trauma to the lumbar region producing fascial defects
Chronic increased intra-abdominal pressure: chronic cough, constipation, ascites, pregnancy
Obesity, malnutrition, connective tissue disorders, and corticosteroid therapy
Heavy lifting and occupations with sustained mechanical strain on the posterolateral abdominal wall

When to See a Doctor?

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

  • New posterolateral flank mass with discomfort, particularly after lumbar surgery or trauma — surgical evaluation with imaging
  • Known Petit hernia with worsening pain, increasing size, or changes in bowel habit — outpatient surgical reassessment
  • Acute, painful, irreducible flank bulge with vomiting or abdominal distension — emergency assessment for incarceration or strangulation
  • Recurrent or postoperative hernia after previous repair — referral to specialized hernia surgeon
  • Patient considering surgery — preoperative anesthesia and surgical risk assessment

Treatment Methods

01
Elective surgical repair recommended for symptomatic hernias and considered in asymptomatic patients to prevent incarceration; observation may be acceptable in selected high-risk patients
02
Open mesh repair via posterolateral approach with prosthetic or biologic mesh placed in retromuscular or onlay position depending on defect size
03
Laparoscopic transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) repair with intraperitoneal or retroperitoneal mesh, useful for intermediate to large defects
04
Robotic mesh repair offers improved visualization and ergonomics for complex or recurrent lumbar hernias in selected centers
05
Postoperative measures include adequate analgesia, gradual mobilization, treatment of constipation and cough, weight optimization, and long-term follow-up for recurrence

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.

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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.