Skip to main content
Log in

The clinical anatomy of the triangle of Grynfeltt

  • Applied Anatomy
  • Published:
Hernia Aims and scope Submit manuscript


Dorsal lumbar hernias are rare pathologies of the abdominal wall. Such hernias may manifest within the superior lumbar triangle of Grynfeltt (TG) or the triangle of Petit. The aim of our study was to identify and describe variations in the size and anatomy of the TG. The triangle was studied in 50 adult human cadavers, and dimensions and surface area were measured. The TG was identified in 82% of cases. Based on surface area parameters, we were able to classify the triangles into four distinct types. Type I (50%), or small triangles, had a surface area of <5 cm2. Type II (22%, n = 22) were defined as triangles intermediate in size with surface areas of 5–15 cm2. Type III (10%, 10) were large triangles with surface areas of >15 cm2. Finally, Type 0 (18%, 18) did not exhibit a triangle; instead, the aponeurosis of the transversus abdominis was enclosed by the external abdominal oblique muscle and the sacrospinalis muscle. We present these data with the hope that after further investigation in a clinical setting, they may serve practitioners in predicting which morphometric variations of the TG most predispose patients to posterior wall herniation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others


  1. Grynfeltt J (1866) La hernie lombaire. Montpellier Med 16:329

    Google Scholar 

  2. Lesshaft P (1870) Die Lumbalgegend in Anat. Chirurgischer Hinsicht. Arch Anat Physiol Wissensch Med Leipzig 37:264

    Google Scholar 

  3. Goodman EH, Speese J (1916) Lumbar hernia. Ann Surg 63:548

    Article  PubMed  CAS  Google Scholar 

  4. Skandalakis JE, Colborn GL, Weidman TA, Foster RS, Kingsnorth AN, Skandalakis LJ, Skandalakis PN, Mirilas PS (2004) Surgical anatomy. Abdominal wall and hernias. Paschalidis Medical, Athens, pp 458–472

    Google Scholar 

  5. Orcutt TW (1971) Hernia of the superior lumbar triangle. Ann Surg 173:294–297

    Article  PubMed  CAS  Google Scholar 

  6. Nyhus LM, Harkins HN (1964) Hernia. J. B. Lippincott Co, Philadelphia

    Google Scholar 

  7. Skrekas G, Stafyla VK, Papalois VE (2005) A Grynfeltt hernia: report of a case. Hernia 9:188–191

    Article  PubMed  CAS  Google Scholar 

  8. Fogarty JD, Hafron JM, Melman A (2006) Renal obstruction caused by herniation of renal pelvis and ureteropelvic junction through superior lumbar triangle hernia (Grynfeltt Hernia). Urology 67:3

    Article  Google Scholar 

  9. Ng SSM, Ng NC, Liu SYW, Lee JFY (2006) Radiology for the surgeon: soft tissue case 58. Can J Surg 49:129–130

    PubMed  Google Scholar 

  10. Salameh JR, Salloum EJ (2004) Lumbar incisional hernias: diagnostic and management dilemma. JSLS 8:391–394

    PubMed  Google Scholar 

  11. Loukas M, Louis RG Jr, Hullett J, Loiacano M, Skidd P, Wagner T (2005) An anatomical classification of the variations of the Inferior Phrenic Vein. Surg Radiol Anat 27:566–574

    Article  PubMed  Google Scholar 

  12. Burt BM, Afifi HY, Wantz GE, Barie PS (2004) Traumatic lumbar hernia: report of cases and comprehensive review of the literature. J Trauma 57:1361–1370

    Article  PubMed  Google Scholar 

  13. DeGarangeot RJC (1731) Traite des operations de chirurgie 1:369

  14. Loukas M, Tubbs RS, El-Sedfy A, Jester A, Polepalli S, Kinsela K, Wu S (2007) The clinical anatomy of the triangle of petit. Hernia 11:441–445

    Article  PubMed  CAS  Google Scholar 

  15. Ravadin IS (1923) Lumbar hernia through Grynfeltt (sic) and Lesgaft’s (sic) triangle. Surg Clin North Am 3:267

    Google Scholar 

  16. Thorek M (1950) Modern surgical technique. JB Lippincott, Philadelphia

    Google Scholar 

  17. Virgillio F (1925) Lumbar hernia. Arch Ital Chir 14:337

    Google Scholar 

  18. Watson LE (1948) Hernia, 3rd edn. CV Mosby, St Louis, pp 443–455

    Google Scholar 

  19. Swarz WT (1954) Lumbar hernias. J Ky Med Assoc 52:673

    Google Scholar 

  20. Hide IG, Pike EE, Uberoi R (1999) Lumbar hernia: a rare cause of large bowel obstruction. Postgrad Med J 75:231–233

    PubMed  CAS  Google Scholar 

  21. Bosworth DM (1955) Repair of herniae through iliac defects. J Bone Joint Surg 37a:1069

    Google Scholar 

  22. Oldfield MC (1945) Iliac Hernia after bone grafting. Lancet 1:810

    Article  Google Scholar 

  23. Geis WP, Saletta JD (1989) Lumbar hernia. In: Nyhus LM, Condon RE (eds) Hernia, Philadelphia, pp 401–415

  24. Patten LC, Awad SS, Berger DH, Fagan SP (2004) A novel techinique for the repair of lumbar hernias after iliac crest bone harvest. Am J Surg 188:85–89

    Article  PubMed  Google Scholar 

  25. Guillem P, Czarnecki E, Duval G, Bounoua F, Fontaine C (2002) Lumbar hernia: anatomical route assessed by computed tomography. Surg Radiol Anat 24:53–6

    Article  PubMed  CAS  Google Scholar 

  26. James EC, Corry RJ, Perry Jr JF (1987) Principles of basic surgical practice. Hanley & Belfus, Inc., Medical Publishers, Philadelphia, pp 352–353

    Google Scholar 

  27. Townsend Jr CM, Beauchamp RD, Evers BM, Mattox KL (2004) Sabiston textbook of surgery: the biological basis of modern surgical practice. In: Hernias, 17th edn, Chap 42. Elsevier Saunders, Philadelphia, pp 1214–1215

  28. Moreno-Egea A, Torralba JA, Morales G, Fernandez T, Guzman P, Hita G, Girela E, Corral M, Campillo A, Aguayo JL (2005) Open vs. laparoscopic repair of secondary lumbar hernias: a prospective nonrandomized study. Surg Endosc 19:184–187

    Article  PubMed  CAS  Google Scholar 

  29. Zhou X, Nve JO, Chen G (2004) Lumbar hernia: Clinical analysis of 11 cases. Hernia 8:260–263

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to M. Loukas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Loukas, M., El-Zammar, D., Shoja, M.M. et al. The clinical anatomy of the triangle of Grynfeltt. Hernia 12, 227–231 (2008).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: