A 7-year-old female who is somewhat obese is brought to the emergency department because of a soft lump above the buttocks. Upon physical examination you note the lump is located just superior to the iliac crest unilaterally on the left side. The protrusion is deep to the skin and pliable to the touch. Which of the following is the most probable diagnosis?
High-Yield Explanation
The lumbar triangle (of Petit) is bordered medially by the latissimus dorsi, laterally by the external abdominal oblique, and inferiorly by the iliac crest. The floor of Pettit's triangle is formed by the internal abdominal oblique, and this is a possible site of herniation. An indirect inguinal hernia is located in the inguinal canal of the anterior abdominal wall. A direct inguinal hernia is located in the Hesselbach's triangle of the anterior abdominal wall. A femoral hernia occurs below the inguinal ligament. Answer A is not the best answer because this lump is described as soft and pliable, which would not likely indicate a tumor, as tumors tend to be hard masses.