© 2002 the Emergency Medicine Journal
CASE REPORT
An unusual presentation of a lumbar hernia
Deptartment of Accident and Emergency, Broomfield Hospital, Chelmsford, CM1 7BU, UK
Correspondence to:
Correspondence to:
Mr S Mehta;
samir@doctors.org.uk
Accepted 31 January 2002
Keywords: lumbar hernia
| The first 150 words of the full text of this article appear below. |
A 64 year man walked into the accident and emergency department with a 24 hour history of swelling in his right flank. Approximately two weeks before his presentation he had developed a painful rash over his right loin. There was no history of trauma. He denied any systemic upset and a review of his gastrointestinal and genitourinary systems was unremarkable. He did however give a history of chickenpox as a child. On examination he appeared well, was apyrexial, and haemodynamically stable. He had a prominent vesicular rash over his right loin in the distribution of T11-L1 (fig 1A
). His abdomen was soft and non-tender with no organomegaly. He had an obvious swelling over his right flank, which became more prominent on standing. This measured approximately 20 cm by 10 cm (fig 1B). The swelling was easily reducible, and a marked cough impulse was demonstrable. A provisional diagnosis of
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