Congenital Superior Lumbar Hernia (Grynfeltt-Lesshaft Hernia) Associated With Orofacial, Limb, and Rib Anomalies: A Neonatal Case Report

Congenital superior lumbar hernia (Grynfeltt-Lesshaft hernia) is an extremely rare defect of the posterior abdominal wall in neonates and is frequently associated with other congenital anomalies. We report a one-month-old female presenting with a right-sided lumbar swelling since birth. Clinical examination revealed a large, reducible mass measuring 8 × 10 cm in the superior lumbar triangle. Associated anomalies included a complete right-sided cleft lip, right thumb hypoplasia with radial deviation, and absence of the lower right thoracic ribs. Abdominal ultrasound demonstrated bowel loops within the hernial sac without signs of obstruction or strangulation. Further imaging confirmed rib agenesis without cardiac, renal, or vertebral abnormalities. The patient underwent successful open tension-free mesh hernioplasty. Postoperative recovery was uneventful, with good healing and no recurrence at one-month follow-up. This case highlights the importance of early diagnosis and treatment of lumbar hernia, particularly when accompanied by other congenital anomalies.