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The triangles of Grynfeltt and Petit and the lumbar tunnel: an anatomo-radiologic study

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Abstract

Purpose

Lumbar hernias are protrusions of intra-abdominal contents classically through the superior (Grynfeltt) and inferior (Petit) lumbar triangles. The anatomy of the triangles is variable and quantitative data are few. No radiological data on the anatomy of the triangles are available.

Methods

Fifty computed tomography angiography of the upper abdomen (M25, F25, mean age 72.5-year-old) were analyzed. The dimensions and the contents of the lumbar triangles were analyzed. The characteristics of the space between the two triangles were also documented.

Results

The superior lumbar triangle showed a mean surface area of 5.10 ± 2.6 cm2. In the area of the triangle, the 12th intercostal pedicle and the 1st lumbar branches of the iliolumbar vessels were found in 42 and 46 %, respectively. The inferior lumbar triangle had a mean surface of area 18.7 ± 8.4 cm2. In this area, the 2nd, 3rd, and 4th lumbar branches were found in 9, 67, and 8 %, respectively. On oblique coronal images, a direct tunnel between the superior and the inferior lumbar triangles was found, showing an oblique course, with a postero-anterior direction (mean length 36.5 ± 5.8 mm, mean caliber 7.4 ± 3.1 mm).

Conclusions

Among the anatomical factors of weakening of the abdominal wall, the course of branches of the lumbar vessels was documented not only in the superior but also in the inferior lumbar triangle. A real musculoaponeurotic tunnel between the superior and the inferior lumbar triangles located in the oblique coronal plane was found, that could play a role in the development of incarceration or strangulation of lumbar hernias.

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Acknowledgments

The authors are grateful to Dr. Gianpaolo Mornata, Dr. Gloria Sarasin, and Maria Martina Sfriso for their skillful technical assistance.

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Authors and Affiliations

  1. Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy

    V. Macchi, A. Porzionato, E. E. E. Picardi, C. Stecco & R. De Caro

  2. Section of Radiology, Euganea Medica Center, Via Colombo 3, Sant’Agostino Di Albignasego, Padua, Italy

    A. Morra

  3. Department of Anatomical Sciences, School of Medicine, St. George’s University, True Blue, Grenada

    M. Loukas

  4. Seattle Science Foundation, Seattle, WA, USA

    R. S. Tubbs

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  1. V. Macchi
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  2. A. Porzionato
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  4. E. E. E. Picardi
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  5. C. Stecco
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  6. M. Loukas
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  7. R. S. Tubbs
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Correspondence to R. De Caro.

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Conflict of interest

Authors Veronica Macchi, Andrea Porzionato, Aldo Morra, Edgardo Enrico Edoardo Picardi, Carla Stecco, Marios Loukas, R. Shane Tubbs, and Raffaele De Caro declare that they have no conflict of interest.

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We declare that experiments comply with current laws of the country in which they were performed.

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For this type of study, formal consent is not required.

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Macchi, V., Porzionato, A., Morra, A. et al. The triangles of Grynfeltt and Petit and the lumbar tunnel: an anatomo-radiologic study. Hernia 21, 369–376 (2017). https://doi.org/10.1007/s10029-016-1509-3

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  • DOI: https://doi.org/10.1007/s10029-016-1509-3

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