Pak J Med Sci 2009 Vol. 25 No. 6 www.pjms.com.pk 1015 Case Report INFERIOR LUMBAR HERNIA OF PETIT IN A PATIENT WITH NEUROFIBROMATOSIS TYPE-1 Safia Rehman 1 , Rooh-ul-Muqim 2 , Raza Hassan 3 , Muhammad Zarin 4 , Mohammad Aziz Wazir 5 , Mahmud Aurangzeb 6 ABSTRACT Lumbar hernias are rare lesions that account for less than 1.5% of total hernia incidence. Only 250-300 cases have been reported in literature. Diagnosis may be difficult because they are either asymptomatic or may present with vague complaints. Differential diagnosis includes a lipoma, a fibroma, a retroperitoneal or intra-cavitary tumor, hematoma or a chronic abscess. They may occur in association with defects of the musculoskeletal system including some syndromes. Lumbar hernia in patients with neurofibromatosis has been reported in a very few number of cases. We report a case of 40 year old female with type 1 neurofibromatosis who presented with left lumbar hernia of Petit. KEY WORDS: Lumbar hernia, Inferior lumbar hernia, Petit’s triangle, Neurofibromatosis type-1. Pak J Med Sci October - December 2009 (Part-II) Vol. 25 No. 6 1015-1017 How to cite this article: Rehman S, Muqim R, Hassan R, Zarin M, Wazir MA, Aurangzeb M. Inferior lumbar hernia of petit in a patient with neurofibromatosis Type-1. Pak J Med Sci 2009;25(6):1015-1017. 1. Dr. Safia Rehman, MBBS, Resident, Postgraduate Student, Surgical C Unit, 2. Dr. Rooh-ul-Muqim, FCPS, FMAS, Associate Professor, Surgical C Unit, 3. Dr. Raza Hassan, MBBS, Resident, Postgraduate Student, Orthopaedics Unit, 4. Dr. Muhammad Zarin, FCPS, MRCS, FMAS, Assistant Professor, Surgical C Unit, 5. Dr. Mohammad Aziz Wazir, MD (USA), FRCS (Edin), FRCS (Ire) Professor and Incharge, Surgical C Unit, 6. Dr Mahmud Aurangzeb, FRCS (Eng), FRCS (Edin), FRCS (Glas), FACS Professor and Incharge, Surgical E Unit, 1-6: Research Unit, Khyber Teaching Hospital, Peshawar - Pakistan. Correspondence DR. Safia Rehman, House 172, Street 7, Sector H-4, Phase 2, Hayatabad, Peshawar - 25000, NWFP - Pakist an. Email: dr_safiarehman@hotmail.com * Recevied for Publication: May 6, 2009 * Accepted: October 24, 2009 INTRODUCTION Lumbar hernias involve extrusion of visceral contents through a defect in the postero-lateral abdominal wall in the quadrilateral that is bounded above by the 12th rib, below by the iliac crest, behind by the erector spinae muscle and in front by a vertical line drawn from the tip of the 12th rib to the iliac crest. This area encompasses the two anatomical triangles, which form the two sites for lumbar hernias. 1 Thus they can be classified as Grynfeltt’s her- nias of the superior lumbar space, Petit’s infe- rior lumbar space and diffuse hernias concern- ing the whole hip. 2 The superior lumbar triangle (of Grynfeltt and Lesshaft) is defined by quadratus lumborum muscle medially, twelfth rib superiorly, and internal oblique muscle laterally. The floor of the triangle is transversalis fascia and aponeuro- sis of the transversalis abdominis muscle. Roof is formed by external oblique and latissimus dorsi muscles.